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/ <br /> ELECTRICAL PERMIT APPLICATION <br /> ClTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8610 - FAX 425-257-8857—www.everettwa.org (� �a 8/ `�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C��o_I J1 <br /> , �� G, C�=���rn'� �L <br /> PROJECT ADDRESS C��� �JS�;� Z <br /> I�DS� � ���� VLl(?NP�vu �2A '12 /�v (�gSvr1 PL �'()t2tTi <br /> Owner MailAddress Ciry StatelZip Phona <br /> Tenanl MailAddress City State2ip Phona <br /> n�o/L;�j ��vcZ �L�C�Z%� 00 �D�'/?ZJ S✓U�/<n�rL��/ �/.e j'�SO �1��17 <br /> Eleclrical ontractor MeilAddress City StatelZip Phone � <br /> �v/L��//l£9�2 J 5' ia� � �N <br /> Slale License Number Conlract Price oi Work <br /> Proposed Use of Buitding Contact Person (Plan Review) <br /> � <br /> Square Foolage(It residential new construction, remodel or addition) <br /> Description of Work to Bc Done: nlE� r.+��`•2�'"`-�'`�`h c r�L ��r � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ��UQ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 fie�eby ceAi(y that I have rttad and examined tl�is application and kno�v fhe same to 6e true and <br /> correct. All provisions o(laws and ordinances goveming this type of woric will be compiefed {-��0 /— �� <br /> whether specified herein or noL The granting of a permit does not presume to give aufhonry fo r� Ei <br /> violafe or cancel the provisions of any other state or local law regulafing construcfion or the <br /> perfomisnce of conslruction. That I am aufhonzed by the ownero/fhisproperty to peAorm fhe <br /> worlc/or whicli applicatior;is made and I comply wilh the Stafe Contrectors Law 18.27 RCW and <br /> 296.200 WA . <br /> , G, -,1y-/Z <br /> Signeture Dele <br />