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ELECTRICAL PERMIT APPLICATiON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � I � oZ� '—� Z <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org �J����S 3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 1 � . <br /> , � �� .: , � � � ...��� 'i .� r �::,.�r�.-�� <br /> l•' i�� <br /> PROJECT ADDRESS <br /> »- \✓ 2 �I�_.:'�I <br /> ��l ��n�-f ��v�,r��tS �:-l�L � .;��lU �.�,,,.� ��'l i%_ro-c � � i , <br /> Owner Mail Address City State/Zip Phone <br /> i t' 1)vcc�'r �✓i'� 4 �,3J� <br /> � f�Yi�} i Zk�-' Lt�(Y�I� l!`�i'L i�.:'.Crw- <br /> �1i� � �L�»V��'�' - _ <br /> Tenant - Mail Address City State/Zip Phone <br /> ,—� l✓�t 9�t i p :", _ _ � t a_i <br /> , ,_ '..;� <br /> t'V�-r.��'tt.� �..���r�;�>��c.�� I i� :>>-('�l lL....f.�� S' � <br /> Electrical Contraclot Mail Address City <br /> State/Zip Phone <br /> 1-�; �,i`J i '�' <br /> ��V��� ��i.`l�!-:=;i.'� �lf'� <br /> State License Number Conlracl Price of Work <br /> , ''' E <br /> r-i � .� �� .,IJ��,-�r- :.c,-�_ � � ��i � _.i : <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residenlial new construction,remodel or addition) <br /> ,-� �, � i.,,,,�.,�,1� I '� .�.,.; —j � .�. �: :r 1�,��., <br /> Descriplion of Work to Be Done: 1 �� �� �� ` � � � ( � <br /> 1 1 <br /> I— I ,L l . �i , \� I .�/.1:U11 1 . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> i: 8E IN RACEWAYS, MC OR AC CABLE. (�'j� <br /> 5b <br /> i CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that 1 have read and examined fhis application and know fhe same fo be frue and �I � I I , I �� <br /> r.orrecL Afl provisions o(laws and ordinances goveming fhis type ol work will 6e completed <br /> ' whether speci�ed herein or noL The granling ol a permd does nol presume fo give authonty lo <br /> violate or cancel fhe provisions olany other sfafe orlocallaw regulafing conslruchon or fhe <br /> performance oI construction. Thaf 1 am authonzed by the owner of Ihis property to peAorm the <br /> work Ior which applicafion is made and 1 comply wifh the Stafe Confracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �i <br /> ;� � �' 1 % � � <br /> � <br /> I �� �y � �l � � � - <br /> 1 <br /> , . . '� Signature ' Date <br />