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� —�-- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982G1 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> a _ ab-�� ` ) <br /> � �;D� �16�5 <br /> � � ll� �Mcr �� AvF �'4�..11C�—� l� <br /> PROJECT ADDRESS <br /> PNIL �.ST�{� � 8�G .SJ�t �i If ✓�Ll�, I� V�E,Q�- tT [,/1} `1 yJ al <br /> Owner �dail�dtlress C�ty State2ip Phone <br /> _,� Sro�Gi-Iuc�SF • �STv�fvi6C <br /> Tenant Mad Adtlress Gty State.2�p Phone <br /> l,, J/�NL �L�G�.? iC �4v5 l�c �viwn�a /�v� l=v�.�; � i,�1- 9�ao i <br /> EleclricalCoNrector lda�lAddress Gfy Slate2�p Phone <br /> ,,, �Zv, GGI- vSl f <br /> ��iH�CC t �19G G7r� �r, 2U1� — <br /> State Licerse Number Contract Pnce of Work <br /> /, J�aN .Si�: ✓ E�ls <br /> Proposed Use ol0uilding Contact Person (Plan Revie�v) <br /> Squa�e Footage(II residential new wnstruc6on, remodel or addition) <br /> Descriplion of 1Nork lo Be pone. / ��� � �� ��� �TS � � J TO�'-/9�' C (.��(J� l S <br /> NOTE WIRING IN NON-DWFLLINGS IS R[4UIR[D TO f-E[ <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �2 �-SD <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceRi/y that I have read and examined Niis app6calron and kno�v lhe samc fo Ge Inie and � <br /> correcf. All provis�ons olli�vs and ordinances goveming this type oI u�orir�vrll be comple(ed � ��a � ��p� <br /> �vhether speci�ed herein or noL The granfing ol a pennd does not presurne fo give aulhonty to <br /> violafe or cancel Ihe provisions o/any olher sta(e or locaf law regulating constrt�cbon oi Ihe <br /> peAom�ance ol constroclion. That I am aulhonzed oy the ov,�ner oRhis/�roperty to peAonn fhe <br /> work lorwhich application is made and I compty wilh(he Sta�e Conlrac(ors Law JB 27 RCW and <br /> 296.�WAC. J ^ . . <br /> /// <br /> � ,1. i� <br /> Signature Oate <br />