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cLECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8610 - FAX 425-257-8857 –www.everettwa.org l0 � �/ —/Z <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM C=�Z/p—d� <br /> '7 �j �C � iJLC�y ���c'r iZ� <<'�j LGic.`�Zc-T/ <br /> PROJECT ADDRESS <br /> Owner MallAddress City State2ip Phone <br /> ���T�"a�,✓ WA.�Y��✓�;z�//"%Z/cr+� .�s�cz�'r' �1.3/�% �nzl» Jt 1L'3 L aL'�'i71 �U� /�LC'3' <br /> Tenanl MailAddress Ciry State/Zip Phone <br /> /J) ///�-� �// � / /,/ � �,��I 76"!� <br /> �,rr..�eli( GL',�^�NE �n'u�i(i..'s C��+CL/b UC7+1 -�T�ti �� �(�L� /�L/�L2� �'�w.Y:f <br /> Electrical Coniraclor Mail Address City State2ip Phone <br /> q2�- 9�7-vv7� <br /> ,/�-Titi�c rti�s �i�I�L F � l 3�5 — <br /> c <br /> State License Number Contract Price of Work <br /> �`�U ti J-��,-� <br /> ���� �` �� �^ �r��� Contacl Person (Plan Review) <br /> Proposed Use of 13uilding <br /> /�6 <br /> Square Footage Q(residentia�new construclion, remodel or addition) <br /> Description of Work fo Be Done: /�7t1�t ��� L-'�4T7� [i^-'�-S i^� i:'L i 7�f�Z i°'zc� <br /> NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FE� �G� <br /> D6 IN RACEWAYS, MC OR AC CABLG. Lj <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceRil,vlhat 1 have read and examined fhis application and know(he same to be frue and � �� r n _ �\�� <br /> correct. All provisions o//mvs and ordivances govemmg Ihis type o/i+�ork will be compleled !il L! V <br /> �vhelherspecdied herein ornof. The granling o1 a pemvt does notp resumr, fo give aufhonty to <br /> viola(e orcancellbe pravisions oI any ofherstate or/ocal/a�v mgule�Gng cor,structi�n or fhe <br /> per,'onnance o/constiur,tion. Thaf 1 am a:dhonzed by Iho ow•ner o1 ihis Ivaperty lo peAomi the <br /> work for which applicafion is made and 1 compfy�vi(b!he Sfafe Contractur:�Law 18.27 RCW and <br /> 296200 WAC. , <br /> / <br /> �...r' _ � - 1���' i � <br /> _ _s� < ��" _ •- <br /> 5ignahrrr" Ua�e <br />