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i-- -- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -ww^n�.everettwa.org � �a6 �� 3 <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM �/�2 _'-7� <br /> 23 v3 ,�' .,« � ff �-� <br /> PROJECT ADDRESS <br /> I , . / qgo3 � <br /> I.J I �-' ChalaGf � �� � /�9i�/ �na,`�`�-,.c W LynnWOad W� ��/-ZrJ �yl -O� � <br /> 5 Phone <br /> Owner Mail Address City StalelZip <br /> Tenenl <br /> Mail Address Ciry SlatelZip Phone <br /> �(�/n P �' Cit SlalelZip Phone <br /> Eleclrical Coniractor Mail Address 1' <br /> State License Number Centract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel oc addi�ion) <br /> Description of Work l0 8e Done: _,nc � " e�-' W <br /> �r c �I'o n-� � P 7�C/ 7`° P U�.✓P/' <br /> ,� ax . �oM � e c- onGPv �'f / io..-, c /'ow� ace w ll � <br /> � nwt� �JaX <br /> -. <br /> NOTE: WIRING IN tJON-DWELLINGS IS REQUIRED TO FEE \ <br /> BE IN RACEWAYS, MC OR AC CABLE. �"�[�j <br /> �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hmeby certi/y fhat I have read and exarnined this application and kno�v the same�o be trt�e and �% I ���� r�� <br /> � conrcL All provisions o/laws and ordinances goveming this type olwork will be,complefed E� I <br /> whefhcr speaGed heiein ornot The granting o/a pemut does not rrsurns fo give authonty fo �i <br /> violafe or cancel fhe Provrsions o(any ofher state orlocal law reguP6ng cons6uchon or the <br /> perfonn�nce o/conslruchon. That 1 am a�rthonzed by the owner o(thrsp roperty(o perforrn the <br /> worlc for which app6cahon is made and 1 compty wifh tlie Sfafo Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � <br /> ��� �ir �7�'C.Piu� � �����-�O j3 <br /> SignaWre II <br />