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ELECTRIC�OL PERMIT /�P'PLICAi'ION <br />�ITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 —www.evereftwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� <br />� <br />� � r � �,�_�T �'%r���GJm� � ��i7 �.�5 <br />y�°-, �F �- �, � <br />PROJECTADDRESS <br />C <br />Owner <br />�' �> ��.. � ; - <br />Tenant <br />l; ; S IS <br />Eleclrical Contractor <br />Mail Address <br />Y -r-c' /� G- � • r <br />Mail Address <br />� �� � / '/ �.S i <br />Mail Address <br />City <br />City <br />5-r 5>� l l ��- <br />Cily <br />, <br />.- C Gv�t��c,���IDu�Fi <br />State License Number ' <br />I-i �� l,'r�z� l� � ur a-a r <br />Proposed Use af Building <br />f residenlial new <br />Description of Work to Be Done: <br />l� t�L � /_ <br />or <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SP.LES TAX CODE IS 3705 <br />StatelZip <br />State/Zip <br />VP [(C// <br />� <br />S�ale2ip <br />Phone <br />Phone <br />ls_ i _7�c'l �� <br />Phone <br />�� y �75 � <br />Conlract Price o( Work <br />�s� •17 ��k' l� c�, i — <br />Corlact Person (Plan Review) <br />1 hereby certily that 1 have read and exarnined this application and knom (he same to b2 true and <br />conect All piovisions o(/aws and ordinances governing th�s type o( wo�k r.il1 be completed <br />whetherspea(ied heiein ornot The granfing ofa pennd does not ��resume tu gi�e aufhonty to <br />violate orcancel the provisions of any other sta(e orlocalla�v regula6ng canstruchon or the <br />peAomiance o/consWr6on. That I am aufhonzed by Ihe owner o(this I�roperty to perform Ihe <br />work /or which apF�lication is made and 1 comply wifl� the Sfate Contractors Lar✓ 18.27 RCW and <br />296.200 WAC. <br />i � ? — <br />t�.�t��C /—:�:5 —l_� <br />FEE --� <br />� I 2c�i - I �2 <br />