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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �aG ��z <br /> 3200 CEDAR STREET, EVEREIT, WA 98201 Id <br /> 425-257-8810 - FAX 425-257-8657 —www.everettwa.org GS/z/D ��� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� � �\ ���J ��.JZ�,� S ��-� <br /> PROJECT ADDRESS <br /> � o.. i_���-� L-c_c� � `IZ � �lG s�- s-� n.1�d�--�A �� ��� �1f&2�( <br /> Ownef Mail Address City StalelZip Phone <br /> �'Z�513 55-9� <br /> Tenant Mail Address City State/Zip Phone <br /> �� �ti��VP��t�� �����v�C, �103 �r��l4 r� ���v��-� W!�- �IFlaS 9�5�s�s�5�- <br /> ElectricalContractor MaitAdCress C�ty State2�p Phone <br /> � <br /> C� U �G��, 01Z� �' � � Do� ` y <br /> State License Number C Nracl Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Foolage(If residential new construction, remodel or addition) <br /> Description of Work lo Be Done: � �uLlGl � ��VS'� p�l� ' l '�U <br /> �i^e,�� � (��n.e,� � Z�AM�� I <br /> I <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> f hereby cer(i(y lH��t 1 have read and examined(his application and knmv(he same to be true and � ,� � � � <br /> correcL All provisions ollaws and o�dumnces govemmg fliis typo ol�vork�vill be cornpleted �'Z' L � <br /> �:hetherspeci(ed herein ornoL 7ho grmiting o(a pemut does not resume to give aufhonty to <br /> violate orcancel the provisions o/any ofher sfafe orlocal law�eguPfing consfnicfion or the <br /> peAomiance oI conslrucfion. That 1 am mdlianzed by the owner o/thisp roperiy to pe�lomi fhe <br /> � n�ori<!or which applicafion i made and I compty wifh fhe Sfate Contrac(ors La�v 78.27 RCW and <br /> 296.200 WAC. ; <br /> % <br /> ' I � C• � 2- <br /> < Signature D le <br />