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1 <br /> ELEC�RICAL PERMIT APPLICATiON <br /> CITY OF EVERETT PERMIT SERVIGES <br /> 3200 CEDAR STREET, EVERETT, WA 982�1 <br /> 425-257-8610 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS MRE ACCEPTED FROM 8 AM TO 4 PM <br /> I 0001 .j.�� Dl�S� �.��i� �V��1�lGl �� <br /> PROJECT ADDRE33 <br /> �,�1�►�' 12$I�.��� � sr�l��dU�1��1rD�G+�/1 q��i7'� <br /> Owne� MailAddress City State2ip Phone <br /> h � �l/ �/�7W� ����� <br /> TAnant � MeilAddress City Stat Phone <br /> �r�P�s��Y► ��'(� U �2�5 C�Q��iel d S��UM�l�I W, U�61 ��n22 <br /> Electricel Contractor MailAddress Ctty SWte/Zip Phone <br /> � <br /> ,�r.ec�e�e 98y�� c� <br /> State License Number Conlra Price of Work <br /> r� ,� �i N� R��iAe�r� 2�� �� <br /> Propos Use of Bui!�+i. ,v C n ct Person (Plan Review) <br /> 22� <br /> Square Footuge(Ii residential new construdion,remodet or eddition) <br /> Oescription of Work to Be Done: <br /> 2�u ��,0 vnd� ���w S�w� r��l d� <br /> N07E: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SA4ES TAX CODE IS 3105 r� <br /> f here6y cer5'Iy that l hsve resd snd examined tl�is applica6on and know the seme to be trve end �I a(�- ('p�� <br /> Correcf Alf provrsions o/laws and orciinanpes goveming this type ol work will be completed <br /> whetherspecified herein ornoL The gmntlng ofe permrt does notP;ssume fo give autho�Vty�o <br /> violate orcancel the provisions of any ofherstate or locel law�egulating consfruction orthe <br /> performence of construdion. That!am autha'rred by the owner ol lhisp roperty ta per/orm the <br /> wo�k Ior which applicaHat is made and I comply with tho State Contractors Law 18.27 RCW and <br /> 296 WAC. <br /> U �12 <br /> SignaNce Dete <br />