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ELECTR�GAL PERIV��T A�PLICATION <br /> ClTY OF EVEREI`T PERMIT SERV�C�S <br /> 3200 CEaAR STREET, EVERETT, WA 98201 <br /> 425-2v7�8810 - FAX 425-2�7-8857 -www.everetfwa.org <br /> APP�.ICATtONS ARE ACCEPTED �ROlN$AM TO a PM <br /> f 0022 �3�" ��e� SE �v c�e�}- <br /> PROJECT AUDRE;SS <br /> C��� <br /> e y 2.8 i a E ��� I l v I�� 9 8�� ���2Z� <br /> Owner Mail Addrass City State/Zip Ahone <br /> �� <br /> Tenant r Meil AdtlrESs Ctty State/Zlp Phone <br /> �re.cs,si o!t. Ee��►-�� �2C1S� �ar-��e lc)i S�. �r1 v�Gl�,� �� �}80 ZZCB�� <br /> �IBCti1C21 CORtTaCtOf Mail Address Crty State/Zip Phone <br /> �2�.C�.�F� `�$W L5 ��: � <br /> State LiCense Number Contract price of Wprk <br /> -1��1 2�.�1 5;Y ( Yv�i ���yT�''O Y� <br /> Proposed Use of BuildFn ContaCt PersUn (Ptan Review) <br /> Square�ootage(If residential new construction, remodef ar addition) <br /> Description of WOrk to He Done: Tp�M p 17C,�P _ <br /> fVOTE WiRING fN t��ON-DWELLINGS IS REQUiRED TO FE� <br /> BE IN RACE'JVAYS, MC OR AC CABL�. _ �� <br /> CfTY OF EVEREtT�OCAE.SAR�S TAX CODE IS 3'fQ5 <br /> �.J O <br /> 1 he�by certify that!have�ad and examined this ap_ icaflon aad know the same to be true and ' <br /> corr�ct AI!pravisions aflaws snd orU►nances gove�g tl�rs type of worlt will Ae completed � I ��� � � ( <br /> whether specifred her8in or not. The gr�n�ing of a permrt does not pr�ssume to give sufho�ity fo <br /> vialate or�ance!the pr��visfol7S o(sny�f��er sfafe or local l�vr�yuleting corrstruction or the <br /> pertormance of canstnn:tio». That!am aufhorrzed by the owner of thrs�ropeitJ�fo perfarm ths <br /> work for which applicatfon is m�de and 1 comply wi#h the Slafe Contracfors Law i8.27 ftCW and <br /> 2�6.200 WAC. � <br /> � � <br /> �gnat Dat <br />