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ELECTRICAL PERIIIIIT APPLICATION I�� <br /> C17Y OF EVERETT PERMIT SERVICES i <br /> 3200 C[DAR STREET, EVERETT. WA 96201 � `�.-a �� <br /> 425-257-8810 - FAX 425-257-8857 -www everettwa.org ' ; <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �" � 3 D� <br /> i ) ( (- i'���I[c-i- .,1i,-r" (i,.. f. t 11 _�: �r�ir.'I --- I� <br /> PROJECTADDR�SS <br />. L`I�r i�,'�,k . � � '�,,. ., v,.n. � �A /�,iC, '�1 i 7c�;;;;L, ',, <br /> r �,� �l� ,��.,,��c a�-� E r �. <br /> OWnaf MailAddress City S telZip Phone i <br /> Tenan� MailAddress City State2p Phone I�� <br /> �.,l�ti i I I <br /> Eledrical�Contraclor Ma�lAddress Cdy State!Zip Phone <br /> State License Number Contract Price of Work <br /> �.i. `,i�} ,�� :. <br /> Proposed Use of OuilJing Conlac�Person (Plan Review) � <br /> I I <br /> iSquare Footage (If residential new conslruclinn, remndel or addition) <br /> �' ;�'"c�� ?lllwtt. <br /> � Lescription of Work to Be Don��, R-i= Ol At i nJ�' �Ct` i,.,_-1����'+�`''EZ ��u �"'�/ 2C-�- �„ �+...r-�tZ <br /> . ��i�`y -------- -- <br /> NOTE VJIRING IN NON-DWELI_INGS IS REQUIRED TO FEE <br /> , E3E IN RACEWAYS. MC OR !�C ('ADLE . <br /> I� � <br /> CITY OF EVERETT LOCAL SALES TA% COOE IS 9105 - <br /> I hc�eby�:crGly(h,if 1 havc�end rind erarnined fhrs,ipplir.nhon und kno�•, thu sunre fo bc true and � <br /> ���,r�ar,( All provr.;ions ollaws und o�dinances yovr.ming this f}po ol tvorH n��ll bn compleled � Y ( <br /> �•.Nefl�crspeahr.d ho�eln ornol. Ihe�rantiny ol a pennd Aons not��resunic lo�ive aufhonty to � ( �� �°'� - � " �i <br /> �,i,d;do or r.;�nccl tho �rovisions ol any ofher sfafe orincaUn�v�cyu��hn�cun-;f�uction nr the <br /> ���v/nnnance oI cons�rucf:on. 7hat I nm aulhorized by fhe oevner ol this p�nperty to peAonn Ihe <br /> �.�.�nk lo� which auPlico!ion is mnde anJ 1 comply wdh thc S(�i(a Contiach vs 1;nv 1&27 RCW nnd <br /> :'96' 200 WAC. <br /> ( -'' �) <br /> ,r, ,_ -- - -- � I �- E_� z o�Z -- <br /> � ;�gnature _'—_—_.___—_-- Date <br /> I <br />