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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8610 - FAX 425-257-8857—www•everettwa.org <br /> APPLICATIONS ARE ACCEP7ED FROM 8 AM TO 4 PM <br /> � i�u i�F���YC rkLF <br /> PROJECT ADDRESS <br /> `{t,S 2>4+0{ <} <br /> ��,y,YY n �� D�6.2PN5) �-�� Po eok lZol CuF.�eF.T'r' WA 482v4 4ZS 1S 2- �l t7 <br /> Owner Mail Address Ciry State/Z�p Phona <br /> =u4�LQxT Wl�r ��701 �ZS2)'i^<f Q7 <br /> � �/ dG .S�JkCG'.TF.�1.L_ jy� S1alelZi Phone <br /> Tenant Mail Address Cily P <br /> � � � 6 No � r- 'T W/L ' - $1T <br /> EleciriCal ontfactOr Mail Address City StatelZip Phone <br /> n�. , r. , r_ i nr,o ni T �+t Z��l�-(�l� <br /> Sta�e License Number Con�ract Price of Work <br /> � Contact Person (Plan Review) <br /> Proposed Use of uildiny <br /> Square Footage Qf residenlial new construc�ion,remodel or addilion) <br /> Description of Work to Be Done: i i i i i .� CY i�9(� l ril-�_����L\�70IZ. D�����F' �� <br /> � ' u-6 l" `� L L t' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � �D .OJ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heroby certily that 1 Irave read and examined this applica(ion and kno�v tAe sarno to be frue and �I ZO Q - D�� <br /> carrect. All provisions ollmvs and ordmances goveming fhis type af work n�ill be cornpleted D <br /> whefher speci�ed herein or not. The granfing of a pemut does not resume to give aufhonly to <br /> violate or cancel the provisions of any ofher state or local law reguPting construchon or the <br /> pedonnance o(cons(n�chon. That I am authorized by the o�vner o/fhisp roperty to pedorm the <br /> �vork for which applica(ion is made and 1 compty wifh the Sfafe Con6actors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> �yj.(� Q� l�' ! Lo12 <br /> � Signalura Date <br />