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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � v i9 ��3 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> C i3oa—il�f <br /> � � I � � verz� �� � <br /> PROJECT ADDRESS <br /> C C:i�e�i G ���,. �1j'2�2 �I LL� 17' '7 0 Z Q / <br /> S�i�;c.� ,J1 SN�:�t�:n��ti� G...�t <br /> Owner <br /> Mai�Address City Sale/Zip Phone <br /> Tenant <br /> MailAddress City Slate2ip Phone <br /> � � ,� c���l.C;,j i/LS_7Y0- �r0 <br /> � le ���� tlr.. f-r�'� 'iH144 Cyr�Rni,� ve ��r.�� eJ., <br /> Elecirical Con ractor <br /> MailAddress City SlatelZip Phone <br /> �.L.E w �F� �i 1 � v �ti/ S�!�, z5 <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Reviev+) <br /> Square Footage(If residential new construction,remodel or addition) <br /> Description of Work to Be Done: ���`� t�" �"P 'ta � �' R e��l au <br /> ,�,,aaJE c�J:.� LJ e�- �'�-T �,.. I�!�_i-�1.�� ��1 n c e � 1 ���r F �lC P�r.�S _ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �� C�� <br /> � <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhat 1 have read and examined this application and kno�v tlie same to be tnie and � I �OZ_ � ( 4 <br /> conecL All provisions ollaws and ardinances c�ovemmg Ihis type olwork�vill Ue complefed � <br /> �vhefher speci(ed hemin or not The granhng ol a pemut does nof resume lo givo aufhonty to <br /> violafo orcancel tho prov�sions of any ofherstafe orlocal law reguPfing construclion or U�e <br /> perfomiance ol constnicfion. That 1 am autho�ized 6y the ownero/lhisp roperty to perfonn fhe <br /> work Ior which application is made and I compty with tho Stato Contraclors Lnw 1827 RCW and <br /> 296.200 WAC. <br /> w� �� �L 1 `9/ "Li�3 <br /> Signat e Date <br />