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i <br /> � <br /> 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.everett�.va.org 3 ` s�l -3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM /�/3� 3_D�6 <br /> L <br /> zy o y i�AN D AV��=� "'— � � - <br /> PROJECT ADDRESS <br /> �, y�Sl <br /> G�L�,N U iNv�s i����s L�� z� zo ��c �'y Rw= 1�) �a3'9z <br /> Owner <br /> Mail Address City SlatelZip Phone <br /> Tenanl <br /> Mail Address City State�Zip Phone <br /> L(C :, i - (-�C."_' �. �0 � <br /> Eleclrical Coniracl <br /> Mail Address Ciry SlalelZip Phone <br /> I�c�'; <br /> /t/C�: IN�L �C � N J Coniract Price oi Work <br /> State License Number <br /> Pwposed Use of Building Conlact Person (Plan Review} <br /> Square Footage Qf residenlial new conslruction, remodel or addition) <br /> Description of Work lo Be Done: �C�U�C� � A'U�-� �' ��'N� ��� �r---� <br />-. L .- u = r � ou Ar.e� �fLP� p �� /2 - �oa h�.a�° suF; <br /> I �`u� <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. Q�/�U, <br /> �� � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> II hemby r,ertily Ihat I have read and examined(his applicafion and kno�v fhe same to be Lue and ��2 j�� ;'l�� <br /> correcL NI provisions o(la�vs and ordinances govenung Ihis lypo ol�vo�k u�ill be completed )(/ �/ <br /> n�hethe�specified herein ornoL The granfing o(a pennd does not resume to give authonty to <br /> Ij violate or cancel fhe pravisions o/any ofher sf�te or local la�v reguPhng consfn�chan crthe <br /> pedomiance o/constnicfion. That 1 am aufhorized by the o�a�ner o/fhis�roperiy to pedomi the <br /> �vork lor which app�ication is made and 1 cornply�vdh rhe Stafe Confrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> , 3- y - �3 <br /> �, ig� � � Date <br />