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r <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ����Z <br /> 425-257-8810 - FAX 425-257-8657—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ����`��� <br /> �/G30 C�(b� ���e <br /> PROJECTADDRES <br /> T��nn .f v��� `163o Co��i, /}�.c �VP/�� � �`�7��97�� �7Z <br /> Owner Mail Addresa City Slate/Zip Phone <br /> Tenanl MailAddress CNy Slata2ip Phone <br /> /� I��eF(tc�r,� lo7ZS 9" PC.1�� Ctil2eJ�tvr�! [✓i9 9C�I` ('f?�2xi-o4�� <br /> Eledrical Contrador Mail Address Cdy State2ip Phone <br /> �N�-�av�sy� zQ U �� <br /> Stale License Number Confrad Price of Work <br /> Proposed Use ot Building Conlact Person (Plan Review) <br /> Square Foo�age(I(residential new construction,remodel or addition) <br /> Description of Work to Be Done: I�f��1 �w� ��a� I � y V t�f ��a��� IJ �� �� <br /> Q� �l o�/1C.1 — <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS I5 REQUIRED TO FEE �� <br /> BE IN RACEWAYS, MC OR AC CABLE. C � <br /> J <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceAify tfrat 1 have read end examined fhis application and know fhe same fo be lrue and -� /� / <br /> correct. All provisions ollaws and ordinances govemmg this type o/work wi116e complefed ��C� IQ "' D� <br /> whefhers/�eafied herein ornot. The granting ol a permd does not presume to give authority fo <br /> viol�to or cancel the provisions o/any other state or local law regulating consfruction or the <br /> peAormance ol construction. Thaf I am aufhonzed by the owner ol this�rnperty fo peAorm the <br /> work Icr which application is made and 1 compty with tbe Stafe Contrac ors Law 19.27 RCW and <br /> 296.200 WAC. <br /> � 6 �13 IZ <br /> � D te <br /> Signature <br />