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( <br /> ELECTRICAL PERMIT APP�ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.evereriwa.org C�z9,�1 Z <br /> J <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��Izas -I�R <br /> ///�� C t�r�GQ�=atN ��4 � CS�6/�L ���J . <br /> PROJECT ADDRESS <br /> ,�vcRGQky /9�UPr/z %/��S � �-G <br /> Owner MailAddress City Stata2ip Phone <br /> Tenant Mail Address City State2ip Phone <br /> 1�����Q /�Lr.ci�ic ���.5 J/r ��l�e. I��: ��/a/r� IRJ� �'�� �yLS,�.l�/J Z <br /> Eledrical Contractor Mail Address Ciry State2ip Phona� <br /> ��v�r_�.C-�%9105 ��Sc� - <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residenlial new construction, remodel or addition) <br /> Description of Work to Be Done: /,• < l�r� ~(.V E y� � J (/)5"1 ,? G �C� <br /> �� �� �CCI �p �� (n'CS - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAPLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that 1 have read and examined this applicatlon and know the same to be true and ��q <br /> correct. All provisions of laws and ordinances goveming this type o(work will be completed G�� � ! <br /> whether specified herein or not. The granting o/a pennit does notpresume to give authority to <br /> violate or cancel the provisions of any othersfafe orlocal law regulafing consbucNon or the <br /> peiformance o(construction. That 1 am authorized by the ownero/fhispropeAy to per/orm the <br /> work for which applrcation is made and 1 comply with the State Confrecfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> -----_ . � Ds' 2 9 Zo! 2 <br /> ignaWre - Date <br /> — - - ___� <br />