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__ _ _ _ _ _ _ l <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��� U�� (',�r�•�� �„_;� '�� `��2� ( 6��-4� � 30o Sr� l � o 0 <br /> PROJECTADDRESS <br /> i � <br /> �}"l,� t.1vt�1 .�(r"�t��' --------- ---� <br /> Owner � ���IAddress City Slate2ip Phone I <br /> i � � <br /> �O✓� � �5l i7Wy���/� � � �(s�N .� �`� � �IO �r/l <br /> �enant MailAddress Cily Stele2ip Pho'0 <br /> �fl ? <br /> /��I G.���,.t�r.v � �Gr_��_ ��12�� y�/l,�,t � � �, �l�.l� W• A, �Sv�L 3�v� <br /> -�`r—� Mal Address City SlalelZip Phone <br /> [Icclrical Contractor <br /> � , pD <br /> n � � , L-�- � � � L �� Contra t rice of Work <br /> Slato License Number <br /> Pr�sed Use ol�ding Contact Person (Plan RevievQ <br /> Square Foolage(If residenlial new conslruction,remodel or adduion) <br /> Ucscription of Wo�k lo �e Done: � L'U A -�-�-�J+�-� — <br /> � <br /> � J !„ �� ' #- <br /> ` �J <br /> NOTE WIRING IN NON-DWE!LINGS IS R[QUIRf_D TO FEE <br /> l3E IN RACEWAYS, N1C OR AC CAf3LE . �� Q� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> I heiehy cnriily lhn(I/�nw�ead and examinr.d(his r�pplicafion and kno�v fhe snmo(o bo f�uo nnd C � <br /> correr,L All piov�sions o/hvvs and ordinances govem:ng Ihis type ol�tiork�•rdl6e compleled � ( 2 I � �(^l(� <br /> v;hethcr spr,cdicd heiein ar not. I he granting o/n pemnf does nofp msunro to give au(ho�i(y:o <br /> viola(o or cancel tl�3 p�avisions ol any olhersfate arlocalla�v regulaling consfruchon or the <br /> � pc�lormonce ol consfiuc(ion. Thaf I am aufhoiizr.d by the ownerolllus �roperty fo pedomi Uio <br /> r.roik/or��hich npplica(ion is mado end I comply wi(h fhe Sfafo Confrac�ors Latv 18.27 RCW nnd <br /> 296.20p,�VAC. <br /> ,�, <br /> P /J <br /> _�"/��T,,��. �� �C� _ � ✓ ���� � V _ <br /> SiqnaWre Dale <br />