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ELECTRICAL PERMIT ,APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> ��P�S' H�yT „ " �2. <br /> PROJECT ADDRESS <br /> � ;w, �',�q J;y �� /� �s — �/d.. T !�/e ��Je.riz�. �/" �,c,b_- 7 8'za i <br /> Owner—� Mail Address City StatelZip Phone <br /> Tenanl MailAddress City Slate/Zip ,�j Phone <br /> � �/��so <br /> ���1.�� l� �Tn�� x„�c• S9o/-n�7S sr rt�Q,��Tl6�T���K r,✓�• �3as�3 s <br /> Elect�ical Co t aclor MailAddress City State2ip Fhone <br /> l JQ �e2ZGU �`bJ✓� � 20�, oJ <br /> State License Number Conlracl Price o(Work <br /> �� 7 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(It residenlial new cons�ruclion, remodel or addilion) <br /> Descriplion of Work to Be Done: S`Q-`�'` J'� �' �-� , �-P�a-c "-� �� <br /> V1��.J E<<e�T � • e��iT�h <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 CODE IS 3105 <br /> 1 hereby certily that 1 have read and examined this application and know tiie samo to be true and ��Z� O_ �I <br /> conect. All provisons ollavos and ordinances goveming this type of woiic will bo comp/eted <br /> whelher specified hemin or noL The granling o/a permd does not�resume to give auihonty lo <br /> viola(e orcancel the provisions o(any otherslate orlocallaiv ragu/ating const�uchon ordie <br /> peAormance of construclion. That I am aufhonzed by fhe owner o1 thisp roperfy to pedorm the <br /> werk!or which applicafion is made and I comply with the Stafe Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �._.a.�i��. , � ' � ' ZO 1 � <br /> SignaWre Dale <br />