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o� io���oi3 weo to: a� rax -------- _ __-- 0oo�/aoz __ <br /> EL�CTRICAL PERMIT APPLICATION <br /> � CITY OF EVERETT PERMIT SERVICES <br /> i <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 • FAX 425-257-A857 —www.everellwa.org <br /> APPLICATIONS A4E ACCEPTED FROM 8 AM TO 4 PM I �'� `/3 <br /> C� � ���S <br /> � I� I�1 C�eda� Sfi <br /> � PROJECT ADDRE55 <br /> �on�s�_�"11"1 Ceda�. Sz1- �ve�Q++ � °1a�1 � -_� <br /> Owner Mail Address Gty SlalciZip Phone <br /> �\ ll \\ <br /> 1� �� /! <br /> � ���.� 1�."� �/ � (�M����SI��tT1 �C�I�'. ���7�{ �r7 �����-!�� ��3 �� �Z� � <br /> � fls �lou wis�1 Zo�) <br /> Elecinc�l Conlraclor M11ail AtlCross G�ly St,Ic2ip Phono <br /> qs�'ouYwqZ'��Nm �� U� o <br /> Stalu License Number tract Price ol Work <br /> RPs�o�¢vtti�,l EI.Qc+R� cal �n�n-"�L�a <br /> Propotied Uce of 8wlding Contact Person (Plan Review) <br /> Sy�aro Foota�n(If resitlenl�al new con5truction, remodel or atltlilion) <br /> f�escdption ol Work lo Be Done I L5 a..�a.�.e I �,�(k,u�Q�� �' +���� ' <br /> � ��S w i+rl�a S, 2�1 o u+ls-�S, �1 i ��tS. 3 Sav�o Ke ctt-l-.e Gfi�S, <br /> i ') �foa c'�Q�i+ 3�3oc� C�2u.i�-rS, 5) �S� uRcu�tS +� � Zou- <br /> -- Gi C.�.u�-S . <br /> NOTE: WIRING IN NON-DWFLLWGS IS REQUIRED TU FEE <br /> [3F IN RACEW�YS, MC OR AC CA[3LE. l�pµy� _ � �_� ' <br /> �-1t' l .J -�— <br /> I CITY OF EVERETT LOCAL SALES TAX COOE IS J105 <br /> � 1 hereGy caih/y that I havo read anA�xamined Ihis apPlicafion and Anow fhe samo fo be 7ue and �� I � i, I _ �!�;j <br /> Iconecl. All provis�orrs olluws und o�Jmances govenrrnr�Uns fype ol work �rdl be,complefod � <br /> whether specilied hcrcin o.nof. The ymnfing ol a pemvt d0es nof presumn to grve auPronty fo <br /> Iviolafe or canccl fhc provisions ol any ofhei stafe or local lew regulaGng tonstruchon or fho <br /> peAo�mnnce of conslrucliatl Thot I nm aufhonzeA by the awner ol flr:s proFerty to peAorm fhe <br /> work wh�ch epplm roi �sVnuAe und I comply wifh fhe Sfufe Gon6��clors La�v 18�7 RCW and <br /> ' 29 0 AC. <br /> . � ' ' I � Z � 13 <br /> _i{JuJIu�C d�0 <br /> � _ _ ---- - --------- - - <br />