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��� i <br /> I <br /> ELECTRICAL PERMIT APPLICATION ' <br /> CITY OF EVERETT pERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 42�257-8857—www.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 6 'I6 �� <br /> �/4D6�/07 <br /> �O // s //a l��G�o- wG< <-i <br /> PROJECT ADDRESS ! <br /> `7 7iS �SS ��(/ <br /> �/r.✓ � /G/'jJr�T /G//S //a oJ��r� �/t<l GU� �2� <br /> Q�y� Mail Address City SfatelZip Phone <br /> Tenant Mail Address Cily / �State2lpp�� Phone <br /> `--125���7� <br /> !-�M('r�m�i�� ��.�emS -����3 t� l.e fs-11� st C-2� 4 mc�n _�1F8�52 <br /> Eledrical Cantrador ailAtldress Cily Slale/Zip Phone <br /> �MC.c�rnrnC.q?�c,� <br /> State License Number Contract Price of Work <br /> G"1C1YU O�Y`� <br /> Proposed Use of Building Contad Pe n (Plan Review) <br /> Square Footage(If residential new consirudion, remodel or addilion) <br /> Description of Work to Be Done: r�j�� t�� � �� � /7 �+i� �J�� �1n�Tc'�' �N <br /> NOTF: WIRING IN NGN-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � <br /> �:� 6� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that 1 have read and examined fhis applicafion and know lhe same(o be true and �/ � �� <br /> correct. Atl provisions ollaws and oidinances r�oveming this fype o�work will be.complefed ��j �� ( /��1 <br /> whetherspeci5ed herein or nof. The granting of a permd does not p�esumo to giva authonty fo 1�/ I <br /> violate or cancel Iha provisions ot any ofher stafe orlocal!aw regulaling construcfion or the <br /> per/ormance o/consfrucfion. Thaf 1 am authorized 6y the owner of th�s properly fo perform the <br /> work lor which applicafion is mado and 1 comply wiih the Sfafe Confrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ��� � <br /> Signalure �al <br />