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i--- ---- - -- <br /> ELECTRICAL PERMIT APRLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —wv�v�.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> '`.���> `�):t[' luo'»f.�� 7'-r�l' <br /> PROJECT ADDRESS <br /> '�elli t�c � 3�IZ.5 `�-.c1,�c •,�s����' �vz�ztl t,�%f� �SZc�I <br /> Owner <br /> Mail Address City Slate/Z p P�ore <br /> Tenanl Mail Address City StatelZ�p Phone <br /> C ? L=L�cE�r�� I �C 2.c,�,llo !o*i� o�„e VJ l.-.���nu..u��( _w� SEc�i(r Zcko �j3-W� <br /> Electrical CoNractor Mail Address C�ty <br /> SlatelZip Phone <br /> C3r_"�E[= L 9c�I �--� �' 2 �C�u — <br /> State License Number Conlract Price of Work <br /> C �'l�lr'] �`+_�VYL ` I <br /> �Z Jid� �L� Conlact Person (Plan Review) <br /> Proposed Use of Building <br /> ( oo� d� <br /> Square Footage(If residential new conslructwn,remodel or adddion) <br /> IDescriplion of Work lo Be Dona: V ���� � ���' �C ( <br /> i <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRC-D r0 FEE �.{� <br /> BE IN RACEWAYS, MC OR AC CABLE. �S LJ� <br /> ��� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certdy thaf I have read and exmnined fl�is ap��lir,a(ion and know(he same fo be tr.�e and �I Zl I � O�Z <br /> ' �:orrect. All provisions olla�vs�nd ordinanr.es govenung ihis type ol�voik�ro�i71 be completed <br /> I r;hefher speci5ed beiein or noL The g�anfing o/a Permd does not presunte to give authonty lo <br /> violate or cm�cel the provisions ol any othersfate arlocal Imv mgulating construchon or fhe <br /> pedomu�nce o/cons(ruclion. Thaf!am authorized by(he owner ol this �roperiy to pedorm fhe <br /> c✓ork%r which apPfication is made and 1 comply�i�ifh fhe Stale Contrac�ors Law 7327 ftCW and <br /> �I 296200 WAC. <br /> � /�� <br /> , � o S 2 D "Z <br /> ';�?�-- �� i� i <br /> II Signature Date <br /> � - ----- -----�-- -- --- <br />