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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �.-d 3.- I'Z <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> E i-zo �—o!v <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,�SOy� Rucker�R <br /> PROJECTADDRESS <br /> �v �2�alfy D���on5 3/5' llo�"�' S`�-�ul �.��4»�� �a 98as7 ��s=�ys-ayv <br /> Owner � Mail Address City State2ip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> / !f�(�V�� ��CGI riG .iflC PnBox�Q�9 �/!O/IOM/'��l �f�f�- 7 �� y� 87S'� <br /> EleclricalContractor MailAddress Cify Stete/Zip Phone <br /> /?'lAuaf> r��7� RA �� � <br /> State License Number Coniracl Price ot Work <br /> Proposed Use o(Building Contacl Person (Pl2n Review) <br /> //hZ Syd�cl���`� <br /> �quare Footage Qt residenlial new construction,remodel or addition) <br /> Description oi Work to Be Done: lTG�G� I'" ZD A�P A'�^ �� �� ��A �1 r'G U 1 1 "r0�`" <br /> 1�S�2L/'� �— L�f✓Cr— <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 /> I hereby ce�tily that I have 2ad and examined fhis applicafion and know the saroa fo 6e truo and �7r� <br /> correct. A!I provisions ollaws and ordinances goveming this type ol work will be completed � CJIJ�— � �� <br /> whether specified herein or noL The granfing ol a pe�md Aoes nof resome to give authonty to <br /> viola�e or cancel(he Provisions o/any other state or local law reguPting construction or the <br /> peAormance of constiuction. That I am authonzed by the owner oI this propedy to perlorm the <br /> wo�k!or�vhich applicalio�made and 1 comply with the State Contrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � o <br /> ignat e Date <br />