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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.everethva.org <br /> �.�_ �-�a <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM G��,a „��I <br /> 3310 Pa��r.� ���tn�� �c�^�,r4.1� 9`b3b� <br /> PROJECT ADDRESS <br /> c � l.ln�vloth'� UJZILte r705 5 --� � v� SS1E. �A1h� C2m2V•� Sr�1?�.,1 �i'����• <br /> j�\ � � Ph e <br /> Owner Mail Add2ss City <br /> �, � �o L�i�5�3-5��- '6i35 <br /> \CW�.t1it1"'�C« L\�"�Yte�l � � 3�IC� I 2v.� R�c � �,c �'�'C (� � StalelLip Phone <br /> Tenanl Mail Address �'ry <br /> �ll�t N"icr 9`bo0 N�vi�r�r �17�C�.ySv �S�� ^J�v6C� li-iv w`t �183•�3 �ya51Z ��q�tic,�N�t <br /> Eledncal Contrador Mail Address C�b <br /> StatelZip Phone <br /> a � �po 00 <br /> 1I�`,�� � �- ^C����J� ConlractPnceofWork <br /> Stale License Number <br /> 4�l"f iZow 4 — <br /> �Cil\y�4'v C��� Contact Person (Plan Review) <br /> Proposed Use of Buitding <br /> Square Footage(If residential new construdion,remodel or addition) <br /> DescnptionofWorktoBeDone: CbY�V�Ec� i���bv�l�nzt' �ti `��`�' c'���"��'} � <br /> �-��„� .. . ,A _ <br /> NOTE: WIRING IN NON-DWELLINGS IS REl]UIRED TO FEE —^ <br /> BE IN RACEWAYS, MC OR AC CABLE. ��</TJ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 bemGy cerLfy that I have read and ezamined this applicahon and know tho samo fo 6e true and �I �` � ! I I � <br /> correcf. All provisions d laws and ordinancos govemmg Ihis typo ol work will be compleled I <br /> whelhe�specilied hrrein or nol. The granling o/a permR does nol presume fo give authonty fo l <br /> violafo or cancel fhe provisions ol any ofher slafe or local law regulaling cons(rucfion or Ihe <br /> pedormanco oI consln�ction. Thal I am authonzed by fhe owner o/Ihis property to perform the <br /> work for which application is mado and 1 compry with Iho Stalo Contracfors Law 7827 RCW and <br /> 29u^200 WAC. <br /> ��� � � � ���� �a <br /> Signature Date <br />