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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT S�RVICES p ��� Z <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I I <br /> 425-257-8810 - FAX 425-257-8657 —www.everettwa.org `/ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM G� %�'9 ��d II <br /> �� � � � ���?z/�y lZ� �°`��`��l�7/ `1��°� � <br /> , <br /> PROJECT ADDRESS <br /> � <br /> I �(J 1 <br /> `J �(�' t� y�� � �%.',,� �� ✓1�� r�-S- �a�� .�' 1%/ <br /> Owner Mail Address Ciry State2ip Phone <br /> Tenani MailAddress City Stale/Zip ��hone <br /> "-� � }"�/� CI J/�� �� O c�/ � � <br /> i- <br /> 1��� ����-�tn ��f �>>t�7y���n������� _ � � �.�� �,� �,Fa � y <br /> Elect�ical Cont acto� Mail Address � Ciry � SlalelZip Phone <br /> / <br /> � <br /> ��1���'��� �'� l� � � � %� �S� � ���-9� � � <br /> Stale License Number Contract Price of Work <br /> � y�� -- 3y� - yaa9 <br /> �s,� �C� ,, /�� <br /> , <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> � <br /> �/����1C, �aS ✓��'�� SC��tt-�!�� <br /> Description of Work lo Be Done: y <br /> /��11i`�c 1�1�(/� �� � �1'� J�-��!�1 S�',P �r-�-<-- <br /> c'�t.E� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � ��� <br /> CITY OF EVERETT LOCAL SALES TAX I:ODE IS 3105 <br /> 1 hereby certi(y that I have read and examined this application and know fhe same to be true and � ��O� — OO� <br /> conecf. A/l provisions of laws and ordinances goveming this type of work will be completed <br /> whether spea�ed he�ein ornoL The granting of a peimit does not�resume to give authonty fo <br /> violate or cancel the provisions of any other slate orlocal law regulating consfniction or lhe <br /> performance of constnrction. Tltat 1 am aufhorized by the owner of fhis property to perform the <br /> work for which application is made and 1 compty wifh fhe Stato Contrac�ors Law 18.27 RC W and <br /> 296.200 WAC. <br /> J���� ���ti�<� ; .�� � � iz <br /> 'Signatur Date / <br />