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ELECTRtCAI. PERMIT APPLlGATiON <br /> CITY QF EVERETT PER�IAIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257�5810 - F/aX�325-257-8857—www.everettwa.org <br /> APP�ICATtONS ARE ACC�PT�D FROM 8 AM TO 4 PM <br /> �z �' `���re � � � <br /> PROJ�CT ADDRESS <br /> C�S�� <br /> 281 E pv I� v I�f� q $3'� 5qo22� <br /> OWi1er Mail Addre85 City Sfate/Zip Phone <br /> Tenant Mall Address City StatelZip P�one <br /> � f�/l ����� �2�� �ar��e.�c� � ��'l uw1C�Q�1 '�� �80 ZZ�$25- <br /> Electrical Contracxor Mail Address Ciry State/Zip " Phone <br /> ��C�E� `i�`-1 L5 �2.�00.�� <br /> 3fate License Number Contract Price of Work <br /> Y�/�I 1� <br /> E'roposed Use of$uildin Contect Pers n (Plan Revisw) <br /> SqUare Foofage(Ef residential new constructlon, remodef ar addition) <br /> Description of Work to Be done: �P W�p_�q�P_ . <br /> NOTE: WIRING IN NON-DW�Li.INGS 1S REQUlREO TO FEE <br /> BE IN RAC�WAYS, MC OR AC CABLE. �\'� <br /> �a v <br /> CITY OF �VERE1T LOCAL SAL�S TAX CqDE IS 310g <br /> !he�by certffy that I h&Ve l�ad aRd examined this ap�llC&ti0rl&rTd know the same to be�rue and <br /> COrrBCt. AI!piavisions of laws and Ordl'nsnCBs goveming fhis type Of worfc will be completed � <br /> wh9fher spec��ied heriern ornot. Ti)e granfing of a perm�t doe�npt pr�,sume to give authori�y to � ,1 ) I l ( <br /> vlolste or CBnCB!the provrsions of any other state ot Ivca!law r�gulatirtg�pnstiuCtipn or tire � � �. � lJ — l t —'�" <br /> perfomaance of construction. That I am authortzed by the owner of this properi'y to pe�form fhe <br /> work for wh�ch appllCat�on Is made and 1 comply w�th the Stafe COntractors Law 18.27 RCW Rnd <br /> 2ss.2oo wac. <br /> � <br /> �gnat e <br />