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[fiooziooz <br /> O5/1.�/'2013 11:00 I�AS <br /> . , � <br /> ELECTRICAL PERMIT APPLICATION <br /> GITY OF EVERETT PERMIT SERVICES <br /> 32D0 CEDAR STREET, EVERETf, WA 98201 5 -�3-�3 <br /> 425-257-8810 - FAX 425-257-8857—www•everettwa.org ��_-�S�Ob� <br /> APPLICATIONS ARE HCCEPTED FROM 8 AM TO 4 PM <br /> q .Qx.Q,� W q�w3 <br /> PROJECTA� ESS�$tOY t�-39(a� ��_�'c <br /> .7(�UC�s o <br /> +��I' - i Z�DI �,tiuh ���e S ��P I��',� aS�l2d �575 <br /> Cwner <br /> Moll Atldress City StalelZip Phone <br /> Tenanl MaJ Address <br /> ���, Stale2fp Phone <br /> �jN�MOX�_���� �'(A�}DrS �,�� VYl(lY/1ll11 I •�u�) �/�'I/l�— �Sne <br /> Staln/Zip <br /> Eledrical�donlredor MailAdtlrcss ��ty 7'70'T7Z-�`�S <br /> �q�� � 850 �v� <br /> �;(' 1 I �I�a�f Contract Pnce of Work <br /> Slate License Number <br /> `� Iw �',�r�a I f SL�� <br /> �^/`n���-�(=��'�� Contad Person (Plan Review) <br /> Proposed Use of Building <br /> Square Foalage(If residential new construclion, mmodel ar addition) <br /> Desenplion oT Wark to Be Done: � S � 7ov �.O�f �ir v� f�� f��'� <br /> . , <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FE <br /> 6E IN RACEWAYu,MC OR AC CABLE. ��•Ov <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily thaf 1 have road and oxamined Ihis oppli:ation and know Iho same l0 60 liuo antl � <br /> conoct. All pruvisions o/laws and ordinancos Bovoming lhis typo of work will6e compleled �I ��UC �-- <br /> whofherspeci(ed homin or.nol. The granling ofa pem��l doos not resumo(o givo aufRority lo l �'" �-� <br /> violata or cancel fho pruvis�ons ol any ofhor sfafe or local law roguPfing consfruction or Ihe <br /> pedormancn o/consWction. Thaf I am authonzod by fho owr.<r c/fhisp roporty to porform the <br /> work Ior which application is made and I comply wifh tY,e Sfato Conf�ctors Law iB.27 PCW and <br /> 296.200 WA . <br /> � --�_���.�ll��-:: . <br /> �..�---�-,,-�^ <br /> Ignature Dale �--_"�� ' <br /> � _ <br />