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--- - - --- ---�- - - -- - -- � <br /> I � <br /> ! ELECTRICAL PERMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SERVICES <br /> ;� 3200 CEDAR STREET, EVERETT, WA 98201 ' <br /> 425-257-SSiO - FAX 425-257-8857 —www everettwa.org <br /> I APPUCATIONS ARE ACCEPTED FROM 8 AM TO q PM <br /> � i <br /> I <br /> � � ( ��D ��EJE/1L�l� ��ll LJ� j �� <br /> PROJECTADDRESS � <br /> I ' <br /> (�e�sr B�,Y <br /> IO�vner 1.1�ilAtlCress Gty State�Zip Phone <br /> I 1�i'Sr�t� y ----- — <br /> ' T�nant GadAtlarEss Cty Staleil_�p Phone � <br /> L-�ti R ,Qo�r�s E-�rc,�i� /�c,����.�;, n C���v <br /> F_lectricdl CoMrac�or ;viad Adaress G.ry Stater7ip P^,one '� <br /> , ��G� U- � <br /> S!ate License Number Contract Pnce o(NJork �� <br /> � �f�mn�l 5��-,-� �7�-���, �s � � ; <br /> � Proposed 'Jse o(6udding � Contacl Person (Plan Revievi) 'i <br /> � <br /> � Syvare Fooiage Q(residenUal new conslruchon, remodel or add�lion) I� <br /> Descr.ption o(Work to Be Done /-'7/��_..1 �20 /j��__j�P_�Jp(,-t-_—C'�J–�.—_L4� .__--_ ,�. <br /> G�9,�1tJ_���1,5_��S� C= ---- - -- -------- i <br /> NOTE: WIRING IN NON-DW[LLJNGS IS REQUiRED I O ' FE[ <br /> BE IN RACEWAYS, MC OR AC CADLE . I I ` rO <br /> „ � J <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I herehy certJy that I have read and ezammed(his r+pphcation anU kno�v Ihe saire(e be!nm and ���� � ��� ; <br /> correct All piov�s�ons o(la�vs and oidrnances governmg fhis fype ol�vai< <�nll bc comple(ed <br /> �vhefher specified he�ein or noL The g�anfing ol�pennd does not resume Io grve authoirty fo <br /> violate or cancel(he provisions o/any ofher sfate or Incal law reguPt�ng consWcfion orlhe <br /> pei/o�mianr.e ol conshuclion. That I am authonzed by!he o�vner o(this`�roperty!o peilomi thc <br /> wo,k/or which application is madc and I conrply�•,ith thc Slate Con(r�clors La�v 18.27 RCW and <br /> 296.i OpJlh47C. . <br /> ♦ <br /> /�– <br /> �� ------ 1- Z3— /-3 __ _ <br /> Sipna Date <br /> ( <br />