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ELECTRICAL PEi�M�T �4PPLICAilQN <br />CiTY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-£3810 - FAX 425-257-8857 — www.everettwa.org �—I U— � 3 <br />APPLICATIONS ARE ACCEPTFD FROM 8 AM TO 4 PM <br />9730 /R��v�- z� t�e,-�.7�` <br />PROJECTADDRESS <br />L ��3-D9 Z <br />�' � / Y /9✓c � <br />���Ii ri t� Cdi1dL.-s�c Z� - g°%�!7 /� G.it'ci ` �� v <br />Ownef -�n MailAddress � City S�alelZip � �one <br />Tenant <br />Electrical <br />Mail Address <br />Mail Address � � <br />�.-�Te � �L9�a Q y <br />Stale License umber <br />� /�Sr/n- G <br />Proposed Use of Building <br />City <br />Squere Foolagz Qf residen!ial new conslruction, remodel or addilion) <br />Sla�elZip <br />y.�`s�'P G s � <br />F2t•��a <br />Coniracl Price of Work <br />Contact Person (Plan Revievi) <br />Phone <br />Phone <br />-6 yOg <br />Description of Work to Be Done: _LQQ,� 10o A.�+o �s_tn /+ � =!G �"t G�'�+— <br />fi�Ce• I. .e e ��L....� � i.( Ba'+1..1% — <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BF IN RACEWAYS, MC OR AC CABLE . <br />'���.00 <br />CITY OF EVEftETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certi(y (hat 1 have read and e.ramined Ihis applicafion and kno:v (he same fo be true and '7 ��'l �7 <br />C � � iJ� ' <br />correcL Fl/I provismns of laws ancl ordinances govemmg tlus fype ol work wdl be completed �� `� <br />�vhr,Brer speafied herein or not. ll�e gran(ing ol a pennd does nnt �. msu�na to give aidhonty fo <br />viaafe or cancel thc provisions of any otlierstate orloca/ law regul`7ting consWchon or the <br />pedormance o/construc6on. That 1 am authonzed by the ownerof lhisp roperty fo per(orm the <br />�;orl<for �•�hich applicafion is made and / comply �vith fhe Stafe Contracters Law 18.27 RCW and <br />296.200 WAC. <br />