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1 1� <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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> Z�� ZZ p�ttccs l�� � �v�.v�� k� �,-, a ti � Z � 1 <br /> PROJECT ADDRESS <br /> Ownef MailAddress City StatelZip Phone <br /> Tenant MailAddress City StatelZip Phone <br /> e'1'L�¢.� <br /> sA�ob ���e�Y� �«�:.•�,-;� ��z�a z�MP,-. st wA �ta� �2 (v2s)3a►-�3 9 <br /> ElectricalContractor MailAddress City StetelZip Phona <br /> S'Aco6o�B�`� PD � Noov <br /> State License Numher Conlract Price of Work <br /> Proposed Use of Buiiding Contact Person (Plan Review) <br /> (�� <br /> Square Footage(If residential new conslruction,remodel or addition) <br /> Descrip�ionofWorktoBeDone: C�0.�� �'4' �-CL�ti���ZS���'�� �� Q�� SW ' �C'�"�j . <br /> � ��an up "�IC�C, Pk�'lQ.� olv1� 0� ✓o�anol�n� — <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �Opp <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceAify that 1 have read and examined Ihis application and know lho same fo be true and r I��^ � <br /> correct. All provisions ollaws and ordinances goveming fhis fype o/work will be completed t �Z. <br /> whether specified herein or noL The granfing of a peimit does not�resume fo give authonty to <br /> violale orcancel the provisions of any otherstate orlocallaw regulating construction orthe <br /> peAonnance ol consfrucfion. That I am aulhorized by the owner o/thisp roperty to perlorm the <br /> work Ior which applicafion is made and 1 comply with the State Contrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ,�lA'b � �-�1- 2alz <br /> Signature Date <br />