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i - --- — - - ---------- <br /> -- — ----� <br /> ELECTRICAL PERMIT APPLiCAT�ON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —�^+aw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FR�M 8 AM TO 4 PM <br /> (l `�� > ! ; 7`- �-1 i.,. . : J <br /> PROJECT ADDRESS <br /> _�o r n e�'S1�+?P- � <br /> O��ner Mail Address City StatelZip Phone <br /> Tenanl Mail Atldress City StatelZip �hone <br /> �-�� s �fF��y,� 73/ 2-5��� � �/�,�r„�� �'�2��1. �57�0��' <br /> EledricalCont�aclor MailAddress Ciry StateZp Phone � <br /> r�af� r� c��� �,�C� <br /> State License Number Coniract Price of WorK <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage Qf residential new consiruc�ion, remodel or addi�ion) <br /> li Description of Work to Be Done� F!. e��. r I O{"� V°�+� ! �' `/vu S�- <br /> r <br /> i <br /> � <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAY$, MC OR AC CABLE. �� � <br /> CITY OF EVE'iETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that I liave read and examinedlhis applicatien and kno�v the sa�ie to be Vu�and � 1� O�—O�� <br /> conecL All prov�sions o//aws and o�dinances govenung Ihrs type ol�ro�k��;ill bc cumpleted <br /> � wlielherspeci�ed herein ornoL The granfing ol a pemnt does notp iesume to ive aulhoN fo <br /> violafe or cancel fhe provisions ol any olhersfate orlocal la�v reyulafing cons(ruction or(hr. <br /> I perlormance ol cons(ructron. That 1 am aufhorized by(he owner o/thisp roperty to perfonn fhe <br /> �rork lor which applicalion is made and I compry trith ihe State Contracfois La�v 7d27 RCW and <br /> I 236200 WAC. I <br /> �� , _ ,� �� � 3 S-2�t� � <br /> nalure Da�e <br /> I_ . . _ . . .—_ ._ . _._ _ -- <br />