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� � <br /> ELECTRICAL PERMIT APPL.�CATION <br /> CITY OF EVERETT PERMIT SERV'IC�S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM T�4 PM <br /> 2. Zv.S 5�=� sT <br /> PROJECT ADDRESS <br /> ���.\ S �"e c�w f 2 2d S S�� S% r�v-v t�l- l�l � l c�l Z d l <br /> Owner ldail Address Cily S�ate/Zip Phone <br /> Tenant Mail Atldrnss City StalelZip Phone <br /> C) <br /> _ .� � � � 1«k�� -�.�� �o �ox y yz �1��,� l,J/�--j�232 r�z�.�- <br /> Electrica�Contractor ailAdtlress Cily Slate2ip Phone <br /> i��a-I�N ze�� G�Sl2 � �� S�5U <br /> State License Number Contre Price of Work <br /> lY L�y��1 CJ� �i ✓\ <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage Qf residential new construction, remodel or addition) <br />� Description oi Work lo Be Done: �h/S!��� S�/�'f'� ��z C� � ��S�t"N �f�4 T/L <br /> T +-� /�I�A� J�. � (CC�f 'CG_�.�GI� G � <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE '' l <br /> BE IN RACEWAYS, MC OR AC CABLE. `„/�1 V�' <br /> JV <br /> CITY OF EVCRETT LOCAL SALES TAX CODE IS 3105 <br /> I Freioby certiry Ihaf I have iead and ezamined this applicafion and know fhe same lo be tn�o and � � I I — I �� <br /> conecf. All provisions ollaws and crdinances govemmg fh�s type o/work will be completed Z <br /> K�hefher specifiod berein or noL The granting o/a pemut Aces nof resume fo,qivo authonty to <br /> violate or cancel the provisions of any olher slate oNocal law reguPhng construchon or fhe <br /> pedormance o/cons(rucfioa That I am aufhonzed_by fhe owner o/fhis property to per(orm fho <br /> work lor which apphcafion is made and I comply wdh Ihe Sfafe Confractors Law 18.27 RCW and <br /> 296200 WAC. <br /> � �/� ��/Z(o�� Z <br /> , <br /> � Si9naNre �Oato <br />