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ELECTRICAL PERMI� APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3240 CEDH�: "TREET, EVERETT, WA 98201 � a _ 7 ��2 <br /> 425-257-8810 - FA._ �5-257-8857-www.evereltwa.org L��a��-�03Z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �`� ��l ��e��c'ee�. �c" f F��. �-tt . w ,4 <br /> PROJECT ADDRESS �— <br /> C� �l ��t�`'1 1 �cr[e i-J�.Y l.-icrc"�T C.J � <br /> Owne� MailAddress Cily Slale/Zip Phone <br /> Tenant MaiiAddress City Stale/Zip Phone <br /> �o�cl:r� '�e�•�:c..� S�src�-5 5'io=.�d'.. r�� nr:-c �it ,.:I wA SJ3-969-5355 <br /> EleCiriCalContractof MailAddress Cily Slate/Zip Phone <br /> APPL�� i �-o �b K � � �D , v`� <br /> Stale License Number Coniracl Price of Work <br /> r��s /C' f'!'�/ <br /> � <br /> Proposed Use of 6uilding Ccntact Person (Plan Revlew) <br /> 1 Square Footage (If residenlial new construclion, remodel or addition) <br /> Descriplion of Work lo Be�one: �� �X ���/A ��� m�--.��f-�� ��'`^�`P"` S <br /> ��..-r1.� � -rr � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B[ IN RACEWAYS, MC OR AC CABLE. � � Q� <br /> CITY OF EVERE i T LOCAL SALES TAX CODE IS 3105 <br /> I l�ereb certi(y fhat 1 have read and examined this application and kno�v the same fo be true and � � _ O <br /> correctyAll provisions oflaws and ordinances 9oveming Ihis type o(work will be comp�efed �� �a � �� <br /> whetherspeci�ed herein ornoL The granfing of a permd does notp resume to give aufhonty to <br /> violate orcancel the provisions of any o(hers(ate orlocalla�v regula(ing constnrclion orthe <br /> , peAormance of construcfion. That 1 am au(honzed Gy fhe o�vnero(this properiy lo perfomi tha <br /> wodr for which application is made and 1 compty wifh the Stafe Contrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> /- (,� `� (�--,/ I a- 7� c '� <br /> � Sipnatura L'ale <br />