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ELECTRICAL PERMIT APPLICATION <br /> � ClTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org / � a���Z <br /> b <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM //�6`� !.f� <br /> �_ <br /> ��v'> /�Y'11 �,.L <br /> �'�I ,, �� ( � <br /> �i--�,�,,-,-r-,.+ .�( �<C: - L �� t v t i �i�i,.)(�, <br /> PROJECT ADDRESS <br /> ��'"('��� I(1� �1C( 1��C�Qt�ti,�I �'�i4� i�("�GC11Ui`��t' ��'�„�tt WZl ��`53��1 <br /> Ownef Mail Atltlress City State2ip Phone <br /> �'��vv �a< < ic�< <�� ���� ����tc�.til�ic d�e ��'����e��t- i,��i �lS ,��l <br /> Tenant hlail Address Cily State2ip Phone <br /> i <br /> �e� .i,�����-r�� 1.���1C� l���oG (; �,���,r�; r4c ���1 _ , a�t� ��� _ ��.�� tS�t�� <br /> Electrical Contractor Mail Address City 'tc:elLp Phone <br /> Cr�Cl���i�-1~���X� � �� ���c(', <br /> State License Number Contract Price of Work <br /> tY,�i'�'�I(�'���1 - ►`ece � �n r,��ea �+ �' �t`��7��r-i- C�C��`Y19�1 <br /> Proposed Use of Buildmg Contact Person (Plan Revizw) <br /> �2G�� ��� -y; L�i <br /> Square Footage Qf residential new construction, remodel or addition) <br /> Description o(Work to Be Done: L�L' � "��I-� -(� `��"`� r v� 1�(�� 1 "�-�"� (/'Y b{��,(, Y <br /> � �- �1 �E'V1 ;i l�� l,D � �' � �`� �' �?����� C�I �� �'ti' ������ '� �— <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � O �(j <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 --- <br /> I hereby ceRi(y thaf I have read and examined this applicafion and know the same to Ge hue and <br /> correcf. All provisions of laws and ordinances goveming fhis type ol v�oik will be comple;ed � 1 �O�—� 1 1_� <br /> whelher specilied herein ornoL The,rantiny o/a permd does nof presume to give authonty ro I T <br /> vrolafe or cancel fhe provisrons of any ofher sla(e or local la�+��egulaling consfruchon or the <br /> perfurmance o!construction. That I am authorized by the o�vner olthis property to perlo�m the <br /> work lo�which a lication is made and I comply wilh the Sfate Conhactois L.aw 1827 RCW and <br /> il <"96.200yY� . , <br /> �I � ��� G�2 �-/,� <br /> ig ature Date <br />