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r <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.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,�y:�v c�ak<<<� Avti,,.,� <br /> PROJECT ADDRESS <br /> L�c��s C��� rf 't�Ev4.11 i �DL"c� 'TjYC'ZC�t,vi✓� .AVLnvL. �(.VCIi�, L1.N ��a�l <br /> Owne� Mail Address City Stale2ip Phane <br /> ��� \�•�'riv� 32r� ti r�.i�� ��b�)t: d2�.1i AN(✓�U�C 'L'J�iY'Ch� WH 'I�ic��� L�}l:C�'���' j`�a�� <br /> Tenanl MailAddress City SIatMZip Phone <br /> A���110 ' cti, S �i�oa 1-4a�n�K 1'Iac�,Sv�t� �Tc231Y�.;L��l�co q8a.�� C�i35)��In .S;,`� . <br /> Ele ncalConirador MailAddress Ciry State2ip Phone <br /> RPG�LI�� -i�Li4-nL � IDO. �0 <br /> State License Number Contred Price of Work <br /> COrti��v�t�-c12� ._I��� �nw�� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new consirudion, remodel or addition) <br /> Description of Work lo Be Done: �j�t\4 c'�� t`�U1ti�w�21[t� �`���'L�'�.�•� ����',.� <br /> �--�—'— <br /> ��-o �i.�`i�=�Ca1 C:irCo�1- <br /> — � � <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 3106 <br /> �O � <br /> 1 hereby certi/y fhaf I have read and examined fhis applicafion and know the same lo be frue and <br /> correct. All provisions o/laws and ordinances govem�ng this type ol work will be complefed <br /> whefhor spec�fied herain or not. Tlie granting ol a permrt does nof presume fo give aufhonfy fo <br /> violate or cancel fhe provisions ol any other stafe or local law regulating consfrucfion or fhe <br /> peAormance o/construcfion. That I am aufhonzaJ by the ownero/fhis p/operty to peAorm fhe <br /> work/or which applicafion is made and 1 comply with the Slafe Confracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> '��1���. 4.,1�- I�- i9�-ia <br /> Signature �` Date <br />