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�;,�.fss L--�'c�,�s r �i� f)��3_�37 � <br /> .� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <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 TO 4 PM <br /> �V-�r �2Q-� Uvc�. � g�'Z-�� <br /> PROJECT ADDRESS <br /> � I 0 !(� �� �t� 5� �l,�vv..�._ 1�✓�. I �� G�2 5 -3�� r <br /> � Owner Mail Address City StatelZip �P1�o�ne <br /> Z <br /> �� `��/`� ��/�-'''c !,�-�--� �'v'.e.v��l y✓/9 ��'�3 2s`!" y< 2 <br /> Tenant Mail Address City State/Zip Phone <br /> S��'C, � �S� s. Z.?��-S fi ��}t/7� YV� �j�'0 3 Z 2 S� - <br /> �L.�-7�!C /N�-� S"'l 2'SSS� <br /> EleCtriCal ContraCtor Mail Address City State/Zip Phone <br /> ,`=:e�--[_.�� � o_��1 �_ �� � l� �n�, OO <br /> State License Number Contract Price of Work <br /> ST�G�� �-�/c� !'t�o lw-�-r- <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> Description of Work to Be Done: ��,5�nn`�C�`� ��� Ga���'��� �''�� �'eC,�G���'�-'J <br /> �� CO�'!/(���—� �1� ��� � %� � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �� ! �O <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that 1 have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governin�this type of work will be complefed ,�— � � <br /> whether specified herein or not. The granting of a permit does not presume to give authority to l�l�� ( r l <br /> violate or cancel the provisions of any other state or local law regulahng construction or the !� � <br /> performance of construction. That 1 am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 11 2Z / L <br /> Signature Date <br />