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�. ,M1� <br /> �. <br /> � �. <br /> 1 <br /> f <br /> L <br /> EL��TRICAL PERMIT ARPLICATI�N <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 /> � a-'-'// —/z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �/�2� /� <br /> r� <br /> � � �-� ` �12- � �-'n � <br /> ' PROJECT ADDRESS � <br /> L <br /> ���--� �..1�-�CJ I� �✓L.� �SJ1�4\`�L l,�l� L'.1.�( L�/Ir.C.G�` I � l� <br /> Owner Mail Address City SlatelZip Phone <br /> �'�, 4,`1,�.`1 ��{��2c��f1� �(G��il,�l`F `'1bZC�3 �5�2�`1-�'iZ�Z <br /> Tenant M� dress City Slate/Zip Phone <br /> `?�,�.,f� ✓ ��'c�,��,� �.�1� lJ.12�� ��� ��.t,k'� �l`33 �����-7��..f.� <br /> Electfi CONraCtO� Maii Address Ciry StatelZip Phone <br /> �� ���.�O�L� �-I�-; �� <br /> State License Number Contract Price of Work <br /> ��-G� i�—�-"�'�G�' <br /> Proposed Use of Building Contact Person (PI� eview) <br /> Square Foolage pf residential new construction,remodel or addition) <br /> Descnption of Work to Be Done: � ��1���1 `���� C-� � ►�� <br /> ���'�1�� 1�`1 ��(,..� 1�:�.� ��L ti 1�\ 1�}L�Y1, <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ��� <br /> CITY OF EVERETT 1_OCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerfify Ihat I have read and examined this application and know fhe same to 6e true and � r �r�� O/� � <br /> correct. All provisions ot laws and ordinances govemmo fl�is fype of work will6e completed I � ll� <br /> whetherspea/ied herein or not. The gran�ing o/a permit does not piesume to give authority to <br /> violate or cancel fhe provisions o/any other state or local law regulating consfniction or the <br /> peAormance ol construction. Tliat 1 am aulhonzed 6y the owner ol fhis property to perlorm the <br /> work/or which applicafion is mude and 1 comply witli the Sfn(e Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �%1-�,�"Z�1 ��11�''''� �2�1�����- <br /> 1 g-1„i9ny���e Dale <br /> �J <br />