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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �J'-as— �� <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org �' ��r3 � <br /> APPLICATIONB ARE ACCEPTED FROM 8 AM TO 4 PM <br /> do� ( � � o�' l� � � �� F �2 J �/ <br /> PROJECT ADDRESS <br /> �'oS Fc�+`—`�� N G <br /> �1 �°u. �n, 5 �--�-�. N� � � (�/\a�� y s� � � I e W�l �(Z 5�- 3�� 3�(38 S <br /> Owner MailAddre�— Cit State2ip Phone <br /> /t/J �+�.� �i/�l c' � ✓�� <br /> Tenanl Mail Address City StalelZip Phona <br /> (� �B w. �-4aul j6o �Yo �� 9 `�� <br /> �C7 J n`� �-P f v`+o '� �`o c 1'h V w h �( r�J 2 7 � — <br /> Electrical Conlractor Mail Address Ciry State2ip Phone <br /> 'V1� o..� n�� v � `� � �t c 1 SO oo + t•A-x .-t- P,e r,.� <br /> Slale License Number Conlracl Price of Work 3�, c <br /> � � � �� �w� � v i � S `lo <br /> ��-�'S � cEe�c'� - S � ���\.e rfdN� � oR t'� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> i 1, �'i�z �v � <br /> Square Footage (If residenlial new construction, remodel or adddion) <br /> � � . <br /> Description ot Work lo Be Dona: �P `'�'�J� �`.� ��`3"{l �ti� � h`�� -t ( `'��e � C � ���� <br /> . � <br /> C \ �C � (� S � C ,n �n A'.�� ( A Kdl W\-e {t� laA`i� /�Nd' YYtR�'� <br /> _�iri(ry�n �1 C C � r c v�"� S ( o`�c(' �T +ic�d�'^c���� ,. r s i H o�l� PK <br /> � ���� ,� � c���9es ������ N� ��z..., �,., ���s �; �a�",s , <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 3105 <br /> 1 here6y ceAi(y that 1 have read and examined lhis application and know fhe same to be true and .r.. C <br /> correcL All provisions o(la�vs and ordinances goveming this type o/work will be completed U Z(�J- �3� <br /> whether speci�ed herein or not The granhng oI a pennd does not resume to give authonty to <br /> violate orcancel tbe provisions o/any othersfate or locallaw iaguPting constructicn or the <br /> performance o(consfnrclion. Tltat 1 am aulhonzed by the owner o(thisp roperty to peRorm the <br /> work/or whicb application is mado and 1 comply with the Sfate Contracfors Law 18.27 RCW and <br /> 296.200 WAC. j� � <br /> i <br /> i� <br /> � �?�''.�r� � '%' -��(' � z ' ! v <br /> Si Wre �/.� Date <br /> ' � <br />