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I <br /> ELECTRICAL I�ERMIT A�'PLICA�'ION <br /> CITY OF EVf=RETT P�RMIT SERVICES � _�� �Z <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ' ' / <br /> 425-257-8810 - FAX 425-257-885i —v✓ww.everettwa.crg !���g._-{�(�-� <br /> ` �" 1 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ����� �5 � �� �a �,,�, [��,��rr �ti�,�� °�w i <br /> PROJECT ADDRESS <br /> S�r; b�c i� - �6Z1 inoa�,.� ��r�r ��� C(�A `lfr 2o I <br /> Owner Mail Address City State/Zip Phone <br /> Tenanl Atail Address City State/Zip Phone <br /> ��� N C�61�,ip LL� ZD3 /�•,ee1�..�, /iVE ���n,��"� �l�t l,t!fr 5y�5z `��y-z9y-r� ; <br /> Eledrical Contrac�o MailAddress City Slate2p Phone <br /> � � F�� �t (��� � S`l� �>�� � 23C`-= <br /> S�ale License Number Conlract Price of Work <br /> Proposed Use of Bcilding Contact Person (Plan Revieai) <br /> .���i <br /> Square Footage(If residential new conslruction,remodel or addition) <br /> Descriplion ef Work to Be Done: -��S'�a�� 7 CaTn Cn G��S �- �4"�•�a•i � — <br /> NnTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 <br /> I hereby certily t/ia,t l liave read and exaniined this application and kno�v tho same to be frue and �) Z`'� L Ly <br /> conecL All pmvisions af/aws and ordinances govommg thrs f ype of no�k�s-ill be complefed <br /> n�hetherspeci(ied here�n ornot. The gran(ing ol a pemul does ri�f�nesmno to give au(hority to <br /> violate orcancel(he provisions of any o(her state orlocul la�•✓royu atqig conshuct�on or fhe <br /> perlormance o(constn�ction. That I am aufhoiized by the owner o/tlusp roperty fo peAonn(he <br /> work tor which application is made and 1 compty with the State Contractors Laiv 1827 RCW and <br /> 296200 W/1C. <br /> D <br /> � S- /�{-/Z <br /> � ���� l�. ... � - - <br /> SignaWro Date <br />