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ELECTRICAL PERMIT APPLlCATION <br />CITY aF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVER[TT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - Nnvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />.-�. <br />;� �l /�; — / SS � �) T <br />PROJECT ADDRESS <br />� -9 ---f �. <br />�- / Zo'� � �� % <br />� ,/� ��1q � p✓c e�T� u,�'� — <br />I C/��17 vl �t��l �Y14, N �( //�P '- � Y � 1 l� <br />Ciry Phone <br />Owner Mail Address State2ip <br />Tenant <br />�`v 2� <br />Eleclrical <br />Mail Address <br />� I 2 G��. L. �N L � <br />����Ie��o���J� <br />State License Number <br />Mail Address <br />� d�ts'�.�-�l� �� � :«\ <br />Proposed Use of Duilding <br />City State2ip <br />z2c� Si S�J ��( �T �� ��� <br />City StalelZip <br />�� <br />Square Footage (If residenhal new construclion, remodel or addihon) <br />Phone <br />93 �aG Sl�l n °: <br />Phone <br />�`OurO 0� <br />Coniracl Price of Work <br />Conlacl Person (Plan Revievi) <br />�a�J`� �ZO IZS c.c.,:� <br />Description of �Vork to Be Done: �Z r �c� �1-`�� �� � `� `n — <br />�� �e_c-t �� � .� �-l�c.T:,.. C�JG S•.,kc�� �� �.1`�Q-� �G:c TO �OD.� <br />1� �J i R.z t Q� ,�. �9-0� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE . �/� O� <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily fhat 1 have read ard examined lhis applicafion and knor� lhe same to be true and � I�O$ � 02 � <br />correcf. All piowsions o(la�vs and ordinances 9overnuig this type of �a-o�le v��ll bq completed / <br />rihether speci6ed lie�cin ornoC The granting o(� permd does not resume lo groe aufhonty fo <br />violate or cancel the provisions oI any otherstafe orlocal la��� reguPtuig consfruction or the <br />perfonnance of construction. That I am authorized by the o�vnerof this property to perform the <br />�•�odc (or whic6 applica6on is n ade and 1 comply wifh lhe State Contractors La�v 18.27 RCW and <br />296.200 WAC. <br />� <br />re <br />R � ZF� I y- <br />