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ELECTRICAL PERMIT APPLIC.Al'ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREEi', EVERETT, WA 982U1 <br /> I 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> , �� <br /> , � �� �C' LJO �'_�� ( I�l-� �� l, Q �� � � �� � <br /> PROJECT ADDRESS <br /> <_ . <br />� � 1 ��_, <.� �> -���� ���-� - -- <br /> Owner MatlAtldress Ciry Sta:e2ip °hone <br /> Tenant MailAddress Ciry StatelLp Phone <br /> ��c�c�'1��.�� � � I 1 1,� � <br /> ��FC���� �� `-�C��� -1;� ''� U� ��� 1���-,� < v,,l��_1,�� <br /> EledricalConlractor MailAddress r,;ty �'�j �SAte4'P, � Phone <br /> J <br /> �� �: ,� L� � �" �t-�l � — <br /> ISlale Licensa Number Coniract Prico uf Work <br /> Proposed Use of Ouilding Contact Person (Plan Revie�v) <br /> Square Footage(If residenlial nevi construclion,remudel or addition) <br /> -,r r <br /> Description of Work lo Oe Done: ._�� <_y} �� '��f L� � (( C` l�V � -- <br /> _'��1�_��` , `t; �t" (`_ � 1: I C" c,��' —� I O l l �� �' `� 100�l 1 \C, — <br /> T <br /> c_. � z `�� <br /> NOT[: WIRING IN NON-DWELLINGS IS I�[QUIRED TO FEE <br /> �E IN RACEWAYS, MC OR AC CABL[ . /1 � I <br /> �` � I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> 1 Aereby cerfi/y fhat I have read and examined(his�ipplicnfian�nd kno�v the smno fo Gc frue and <br /> Icarrec(. All provisions o/lar�s and ordinances�ovemmg Ih;s type ol�rark��:dl6e completed <br /> n�hefher speci6ed herein or noL Tho gianGny o/n penn��does not resurna la givo aidhority to <br /> violala or cancel fho provis�ons ol any others(a(e orlacallaw reguPling consfruct�on or fhe <br /> perfamwnco u/consfiucfion. Thaf I arn authanzed Gy tho ou-ner ol(his roper}y�o perinnn Ihe <br /> �vork lor�vnich npplicafion;s rnado and I compty wilh!he SfatQ ContiacPrs Law 1827 RCW and <br /> 296.200 WAC. <br /> \ �1 , I <br /> \ "'1 �_ 1 ; � , ,\ I ' `� � 1 ,1. <br /> ' � � `�_L _ <br /> S��naWre ---- � U:�to . . <br />