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�LECTRICAL P�ER�IIIIT APPLICA�'ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org � -(� �� ?j <br /> APPLICATIONS ARE ACCEPTED FkOM 8 AM TO 4 PM C �30 a -��G� <br /> /��AL� !�:i t,i� z �� <br /> ��i S� cv�REii Y , t <br /> PROJECT ADDRESS <br /> �l�C/L�7T /t'�/I/� U� G� C <br /> Owne� Mail Address City State/Zip Phone <br /> S�c. yn,k � r�H,� -� s�r� <br /> Tenant Mail Address City StatelZip Phone <br /> /��2c-ni 6✓�q ���c?R�c �n�3nx .3rY.3�' S���rrti G✓� ja'�a`� <br /> Eleclrical Contraclor Mail Address City Stale/Zip Phone <br /> � , rj L�L u <br /> (f R U�%l�iG 9-S �f C C�- `. <br /> State License Number Conlract Price oi Wcrk <br /> ('J;�iyt"R�.) � <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Sqaare Footage Qf residential nev+conslruction, remodel or addition) <br /> ' �..��,��,��: 0 �.u��r�, sw,�cACz, <br /> Descriptian of Work to Be Done: �/�S�n�l ��f'Srs <br />' ., -�'r ��(.e n,�,��'� s�v <br /> � <br /> � <br /> I <br /> ' NOTE: WIRING IN NQN-DWELLWGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � �' (C � �(:i <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i1 hereby certily fh�f I have read and examined fhis applicalion and know the same(o De tnre and ! � ���_ �� , /u <br /> correcL All p�ovisions o/laws and ordinances govemmg fhis type of��rork will be completed G � `7 / <br /> wlielher speci�ed herein ornoL The granting o/a pennd does nof reswne to give authonty to <br /> violate orcancel Ihe provisions olany other state orlocalla�v regu�ting construction or the <br /> I perfonnance o�consWc6on. That 1 am authonzed by the ownero�fhis property fo pedorm the <br /> i ivoilc/or�vhich applicalion is made and I compty with the Slate Contractor.;La�v 18.27 RCW and <br /> � 296.200 WAC. <br /> � ��c�/ 3 <br /> I� �9�� Dale <br /> I � - -- ---- --- --_ —__-_ _' <br />