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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET(, WA 98201 � �a3 -�z <br /> 425-257-8810 - FAX425-25�-8857 —www.everettwa.org L�/Zo7—/47 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �.7_.2��7 C=� �� 1� L � <br /> PROJECT ADDRESS � <br /> I � S'7=9� � �.� Y�� 3 � - ���v�9 �bw3 <br /> OWner Ma�lAddress Cit SWIe/Zip Phone <br /> ��-��'LY{-`� i' <br /> J �� <br /> Tenanl����— Mail Address Ciry State2ip Phone <br /> -g�,� �� �`� <br /> _, YIy�..r� ���1it� �'-�IL '?23� I ���S�l&J ' � ,..��4 � �Sil�`=�-hone <br /> Eleclrical Contraclor Mail Addrzss Cdy StatelZiF <br /> Mc�-;; G�-.�d ��f' z-, � i i � � <br /> State License Number ConUacl Price of Work <br /> L� � �k2�7��SS � <br /> Pmposed Use of Building Contact Person (P an Review) <br /> Square Foo�age (If residential new cons�ruction, remodel or addition) <br /> Descriplion of Work to Be Done: �� Gtt-) t r j' '���7f�- ` � <br /> I <br /> NOTE: WIRING IN NGN-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � —i - � �� <br /> I hereby certily that 1 have read and examined lhis application and knoev the same to be true and � 2(� r (� <br /> conect. All prowsions of laws and ordinances goveming Ihis type of work will be complete� � <br /> whether speci6ed berein ornot The granling o(a pemut does not resume to give authonty to <br /> violafe or cancel the provisions o(any otherstate orlocal law reguPting constn�cfion orthe <br /> pedonnance of constnrclion. That 1 am authonzed by the ownerof thisp roperty to perform the <br /> wodc(or which applicalion is made and 1 comply with lhe State Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ; ,,� - -z.�- 1 ` <br /> Signature Date \ <br /> Zv � SS�� �53 C-�,, r <br />