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` c�2�6 -� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 7_ I g_� .Z <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> �Izo�-�7/ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 13oq <br /> � Y�1 �le sf <br /> PROJECT ADDRESS <br /> �(�/�,��el��f 1�a,4Y'�' Ja.ly �Ls °����e <br /> Owner Mail Address City StatelZip Phone <br /> Tenan� MailAddress City Stete2ip Phona <br /> c��� s �-�.���,,� �3� 2so� s� ,����wa� �� Q�q2 3606�� <br /> Eleclrical Contractor Mail Address City Stete2�p Phone <br /> C �a.r��e i C�3`I kq �I G�o� �n <br /> Stale License Number Cantract Price oi Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Square Footage(If residentiat new construction, remodel or addition) <br /> Description of Work to 8e Done: I�e`w��e- fJU�f�� DGC� lxcC !S�4�1 (l� L�✓� <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 COOE IS 3105 <br /> 1 here6y ceriily fhat I have read and examined this application and know the same to be true and ���p�- (��-- I <br /> correct All provisions of laws and ordinances goveming this type of woric��i;l 6e completed <br /> whether speci�ed herein ornot. The granting ol a permif does not presum�to give authonty to <br /> violate orcancel the provisions olany otherstate orlocallew regulating construction orthe <br /> perfortnance of construction. That I am authorized 6y the ownero(this pmperty to perform fhe <br /> work forwhich application is made and 1 comply wifh fhe State Contractors Law 18.27 RCWand <br /> 296.200 WAC. <br /> �� �� 7-r� �/2 <br /> � i9�a���e Date <br />