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lI � n N <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - F�X 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� �.� �a ��.�-�S �� <br /> PROJECT ADDRESS <br /> �v�� C� INtor�. `7 � Cdwx��ds ��r�. �L'cx�e� 1,�� l��d � <br /> Ownef MailAddress City Stale2ip c'� Phone <br /> dCxO�p--����� <br /> � 7 �� <br /> Tenanl MailAddress Cily State/Zip Phone <br /> Ele�clricalC�� MailAddress Clty State/Zip Phone <br /> Stale License Number Conlracl Price of Work <br /> 1�-��C, �.1,�? � <br /> Proposed Use of Building Contact Person (Plan Revie�v) <br />—� Square Footage Qf residenlial new conslruclion,remodel or addition) <br /> DescriptionofWorktoBeDone: ��ct- 6✓l 5����GL � ti�/���%� C-� C <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 /> 1 hereby ce�tily fhat I have mad and examined(his applrcation and kno�v fhe same to be(rue and <br /> correct. All provis�ons olla�vs and ordinances goveming flus typo o(�vork will be completed <br /> ,.1ir.ther spcafied hemin ornoL The gran(ing o/a pernut does notp resumo to give aulhonty fo <br /> :;�I�ite or cancel the prov�sions of any ofherstafe orfocal la�v reyu/afing conslrucfion or(he � ! 7 G � —� �j 3 <br /> prdomiance o(consf�uchon. That 1 am authonzed by tHe on�nerolfhis roperty to pedonrt fhe I li <br /> r.o�k!or which application is made and 1 comply�vifh the State ContracPrs Law 18.27 RC�V and <br /> :9G.20D WAC. <br /> �-. u 1� � ao � � � <br /> ��l� ���— <br /> � SignaWro Dale <br />