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r <br /> __ - ------ _ __------- --- -- ---� <br /> I <br /> I ELECTRICAL PERM��' /�PF'LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, �VERETT, WA 98201 <br /> � 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> � �� i -13 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � �3o a ,o 6i <br /> � ' � / I <br /> ;'�`�/� G���� � � <br /> PROJECT ADDRESS I <br /> ,7 <br /> � <br /> � <br /> Owner Ma�l Address City S�ate/Zip Phone <br /> Tenan� J Mail Address City StatelZip Phone <br /> C'�.c,f-(C� �/P C' , 7 3 j �s��r' �,�.'� ��,ru� lr//�. <br /> Eleclrical�onlractor Ma�!Fddress G��ry State2ip Phone <br /> � <br /> C I��y-,�%�1-^�> 3 r /` a �o — - <br /> State License Number Coniract i'rice of Work <br /> �i1 n '/ l_ <br /> /� t'S ' �G�Y /rt `�__ <br /> Proposeo Use of Building Contact Person (?lan Review) <br /> i <br /> �� Squar2 F�.l ge(If re dential new construction, remodel or addition) � <br /> � Description of Work to Be Done: �GC� , !7�"`�� ` � J / /�x '�e � � <br /> S' �rv , �_� �° ��— <br /> , I� <br /> � <br /> � NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE I <br /> BE IN RACEWAYS, MC OR AC CA�LE. ����� I <br /> � GTY OF EVERETT LOCAL SAL[S TAX CODE IS 3105 Ii <br /> 1 hereby cerli(y Ih�{t I have read and examined this applicafion and knovd the same fo be We and � � <br /> correcf. AI!provisions olla�vs and ordinances govemma this type o(ivark�vill ue complefed t (" '������ ��' I <br /> whelher speci6ed herein ornot. The granfing of a pernid does not resurne to;7ive aulhonly to �—�i �� L_l I <br /> violate or c�t�eei �e iovisions o/any nther stafe orlocal law regu�(ing conswchon or lhe <br /> perlomianCe o/consf ction. Thaf I am aufhorized by the owner ol this property fo perfonn the I <br /> work/or hich applica bn is rnade and 1 comply�vif h/ (ale Confroctors La�v 18.27 RCW and <br /> 296.20 WAC. <br /> � ' `�/D "��l-s� I <br /> � Signature Date <br /> I <br /> . ... _ . . _ _ ___—_—_____—_._._ <br />