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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www•everettwa.org �(--a7�-IZ <br /> ✓�a<< --I G� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C <br /> /232� /�' �N �J� �� <br /> PROJECT ADDRESS <br /> yzs- <br /> r�1A�(..F�.IG (513St.LL lL�� l�1N�S�E. S� �E-��f T��A . �j61�% 77c-hys <br /> Owner Mail Address <br /> City StatelZip Phone <br /> Tenant Mail ACdress <br /> ���Y SlalelZip Phone <br /> �t.fNGn�JC/ �i�r4�,y .�-�-�ic��-S /oZZ� /��IrJ yl l��H�t�,Wo,. °�al y.Br-�2G-4.o <br /> ElecUical Contraclo� Mail Address <br /> City State/Z p Phone <br /> � / <br /> �<�' �O <br /> j t,til D A Gs��;��_-� b <br /> Contract Price of Work <br /> Stale License Number <br /> ���� Conlacl Person (Plan Review) <br /> Proposed Use of Building <br /> Square Footage Qf residential new construction,remodel or addition) <br /> �1GD//!/� GfI�,C! !T ��'�- /'✓Ft�/ fi�C, G{�JT ��jCA�:F� <br /> IDescripiion of Work lo Be Done: — <br /> I <br /> FEE <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRCDTO ��G� <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> ICITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerfily thaf 1 have read and examined this applicafion and know Ihe same to be Irue and f / � <br /> corr�ct All provisons o(laws and ordinances governing fhis type ol work will be completed � � �I I � I �J <br /> w�hefher specilied h�rein or noL The yranfing ol a pernut does not resume to give authonty to <br /> violate or cancel fhe provisions ol any other sfafe or local law reguPfing consfruchon or fhe <br /> performance olyonsfrucGon. Thaf I am aufhorized by fhe owner ol fhis property fo perform fhe <br /> work(or which��!>plica ion is made and 1 comply with Ihe Stafe Conlraclors Law 18.27 RCW and <br /> 296.200 WAC�/ <br /> � r� � ��_�_�` <br /> � ignalure Dale <br />