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OS/17/2013 Pfti 16: 12 PAX 0002/00� <br /> I <br /> ' ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 JC—ao-�3 <br /> 425-257-8810 - FAX 425-257-8t357—www.everettwa.org � <br /> � �'��OS_�11 <br /> � APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � �P �� � �-D ��� <br /> i� PROJ[CT ADDRESS����1� �� �� � <br /> C'le0�e �J <br /> Stii ��P i����,dw�y ��P��e-+-� ��J� ��203 ��P �� <br /> Owner Ma�l nddress City State/Z�p Phone <br /> \l <br /> h �� (I <br /> Tenant MailAtlCress City Stale2ip Phon <br /> i AS you �� s�+ 7.� 7�� <br /> ' �L E C�"T�1 G �p ZS `�J s'�ct �rS'Pf�-F-I-ID �� �J��3� ZS ZS <br /> IGleclrieal Contractor Mail Aeamss � ciry staterzip Pnone <br /> �ls `�c�L�yl,�°IZSr�r� � ��o � <br /> � Siate License�dmber Contract Price of Work � <br /> �J ,��1 G�p yl--�l Gt � SC�Gt�'1 CVl�l G�-� 2--F � <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> I SGuare Footago Qf resi0ential new con6trudion,remodel or adtlition) � <br /> Doscription of Work Io Be Done: '� ` �� � D 7 � 1 �vv�'I� ' " I <br /> fi M 1 V I S G� �� 2 c�� —f � <br /> � �+�� S� uv� � � G� . <br /> IJOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I SD• UO <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certily fhat I have read and examined this applicafion and kno�v fhe same to be frue and � l 3O� � I I I <br /> correct All provlslons ollaws and ordinance5 goveming this rype of work will be completed l l l <br /> v:hetner speaGed herein or noL Tho granling ol a pemvf does not presume fo give aufhonfy to <br /> violato or cancel the provisions olany othorstafe orlecallaw regulating constrocfion or the <br /> perl e ol cons(rucfron. That I am aufhorized Gylhe owner�l this property fo peAorm the <br /> rie c lor w ch applicalio s ade and I comply wifh the State Controctors Law 18.27 RCW and <br /> ZJi.2U0W C. \ <br /> .. . � 1 � I / <br /> gnaluro Dat <br />