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. ___ -- --- i _ -- <br /> �_ - . <br /> i <br /> ELECTROCAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR ETREET, [VERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /�'/y ��E���- <br /> PROJECT ADDRESS <br /> �m��t lyl9'/I�k�'�E,� ��� wq- 98��/ Nj�- <br /> Owner <br /> Mail Address Cny State/dp Phone <br /> Tenan��� IAadAddress C�ry SlalelZip Phone <br /> �,esrc�E�ric iyL��� ��rr c� 98zo�- ��s=.zGGQ-7�3 <br /> Electrical Con(ractor <br /> M11ail Address City Stale2ip Phone <br /> /✓ W / <br /> �l2ST��97//Z�_ ' <br /> Stale License Number Conlract Price of Work <br /> �''- .SFi� G��^�S <br /> Proposed Use of Buildin3 �vntact Person (Plan Review) <br /> IISquareV oo�age Qf residenlial new consiruclion, remodel or addition) <br /> II Descriplion o(Work lo Be Done: Ck�i�V�� (,��1I1=�'-�- ` ��-Q�mI�' �� <br />-. <br /> � <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> DG IN RACEWAYS, MC OR AC CABLE . � �-, l �, <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I1 hero6y certil}�fhat I have read and exa�����t�d Iliis application anAknor+the same to be tn�e and .� � C, <br /> correcL All piovisions olla�vs nnd ordinances govemm9 this fype o/uorlc��rill bo complefed ' ' � �� �� _ I ,1. <br /> i whelhcr specdied heirin ornoL The granling ol u pennd does not resume to give airthonty fo L <br /> iviolate or cancel the provisions o/any ofhersfafe or local Ima�reguPting consfruclion orlhe <br /> peAomiance of cons6uchon. Tha(1 am aulhorized by(he o�vner o(this pi�perty lo pe�fonn the <br /> Iwork lor ivhich ap licalion is made and 1 conrply�vifh fHe Sfafe Contractors La�v 78.27 RCW and <br /> 296.200 WAC: � <br /> � ��d �� y i 7�� <br /> igna ure Date <br />