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i <br /> I ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERViCES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—�vww.everett�va.org <br /> � APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> II <br /> 2 �v I �ve,�-���e A U�- <br /> , PROJECT ADORESS <br /> �I �.e.lJ�s f� d 28�� t,�e.�-,,.��re Au�E ��� �✓(� RB�oI <br /> I Ovmef Idail Address Ciry State2ip Phane <br /> W�,Is �v��o 3�k 280, t�e.���ce Au� E�-er�- w� ��2�� <br /> Tenan� Mail Address City State2ip Phone <br /> II26o8N�.,Yqq Su�f� <br /> ���e�e S 5�:�� �#- A�,,�1�3.�� Mu,.�-r V-v� t�- �a2�3 s��`�Z`���3 Z� <br /> Electrical CoNraclor ldal A ess City Slate2ip Phone <br /> �yt e.f�fl'S �U(2. �c{ �C�c��� <br /> State License Number Contract Price of Work <br /> � ���1� ��� � ���G� <br /> ilProposed Use of Ouilding Contact Person (Plan Review) <br /> iSquare Footage(If residential new construction,remodel or additionl <br /> DescnphonofWorktoBeDone: «�`�� 2 �"^` S��KS lU 1SeP ��e eL��$��'� <br /> i I <br /> I NOTE WIRING IN NON-DWELLINGS IS REQUIRFD TO FEE <br /> �E IN RACEWAYS, MC OR AC CABLE. <br /> G� C��1 <br /> I� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heieby cerhly Ihaf I have read and exanrineo!�us applicafion and kno�v Ihe same fo be We and I� ��; +L <br /> r.orrect All provisions olla�vs and ordinancos coverning fhis fype olwork will be completed C � � � � ` � <br /> whelhcr speci(eA hermn or nol The granfing o!,�pennR does nof presume to gi��e authorily fo <br /> '� violale or cancel flie provisions olany o(her sfatc oi local la�v reyulaling constn�cfion or fhe <br /> � perfonnance o/consf�uclron. Thaf 1 am eufhonzed by fhe ownerol fhis prope�ty fo pedonn fhe <br /> � work/or which�pplic�✓on is made and 1 cornply�•nfh the Stafe CoNracfors La�v 1 B 27 F7C W and <br /> 296200 WAC. <br /> � �/� 2-2'.�-l � <br /> '� Signaturc � Dale <br /> I' _— - _ __—.—_ <br />