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ELECTRI(�AL, PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org 3 — I �"� 3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L��303"��� I <br /> ;/�/ C ll�nr��ti �U� <br /> PROJECT ADDRESS <br /> �� �P l/�1�1 `�.�; 5/.Z7 `17�ti c� <br /> OWner � MailAddress City State/Zip Phcne <br /> Tenanl Mail Address City Slale2ip Phone <br /> K�lS� I'�t._troi� �,�7 /�f��` Sf NE /7Y`�in��Ul� L�9 Cif'+a,�� 5/.75.��I ��i�J <br /> Electrical Contractor Mail Address State2p Phone <br /> ��� Q c ogv c c <br /> � �- � * �1� �A Cont�t Price of Work <br /> State License Number <br /> Propos d Use ot Building Contact Person (Plan Review) <br /> / �� <br /> Square ootage(If residential�ew construction, remodel or addilion) <br /> Description oi Work to 8e Done: /��d � G�c; pl�n��i� /����7c%S iv� 1��'�+�.(��`'`/' '�^ <br /> lLi.G4Y`—^'.� r��=�1+�"Cl,�n�• CCr (.�t�Sh�{� M�r�-��17��G�'� c. } �t11-� C�n- rrlLs'_lS��'%c%J <br /> r <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> t�s'6.Jl� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 <br /> 1 hereby ceriily fh�?t 1 have read and examined this application and know fh,e sarne lo be tn�e and /'� � <br /> co�cL All pmvisions o(la�vs nnd oidinances goveming fhis type ol work will be completed ��?J�3— V� �' <br /> whelherspeci6ed he��in ornot The gianfing o/a pennd does not�rrsume lo give a�dhonty ro <br /> � violate orcancel the provisions o/any otherstate or local law�egulating consf�ucfion orfhe <br /> � perfomiance o(cons(rucfion. That 1 am aufhonzed by fhe owner o(this properiy(o per(onn the <br />— wodc/or which application is made and 1 cornply�vi(h Ihe Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Sig aNr� � ale <br />