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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CED�R STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.evereltwa.org <br /> APPLICATION5 ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� � a�-�z <br /> L�ZI /..1 �7 <br /> Zlp ( 2 C �[S� V1JT ST <br /> PROJECT AODRESS <br /> 't Zs ��0 8�S� <br /> 7�t.��n \� ��lbc ��� Z�a i2 Cl�asT�n.trs-r PJrec.�T v.�ti Q��o + _ <br /> Owner MeilAddress Ciry SlatelZip Phone <br /> Tenant MailAddress C�ty SlatelZp �LL ��v��`�^e <br /> � <br /> �u��t �12C�R�� Z... � S°!0`/ '2 %'-� r.frSc✓ �dl�lT�c4� T PiXc� 1c76� y/N75o <br /> EledricalCon actor MailAddrese C�ty SlaterZip Phone <br /> �° 21 �� = o �sd', � _ fac9V � <br /> J <br /> Slate License Number C ntract Pdce ut Work <br /> t�,z '�."�,E-�`�i. � <br /> Proposed Use ol Building Contact Person (Plan Review) <br /> Square Foolage Qf residential new construction,remodel or addition) <br /> , , � �j � �.,.-��� � �c,..,.-. � �'�1 �. � ��J��b <br /> Description ol Work to Be Done: lZ e �_ <br /> � ,� ' ��� H 5 � TT(7l7 S•'�+ti l! �j 1,Te c.'�o'R t�a_n�-�J�.�cc� <br /> �� �., � 4•�l�. .�i-:X��..n <br /> �y -1 <br /> NOTE: WIRING IN NON-DWEI.LINGS IS R[QUIRED TO FEE <br /> B[ IN RACEWAYS, MC OR AC CABLE. ' 1 � Q � <br /> �L <br /> CITY OF EVERETT LOCAL SALES TAX C��DE IS 3105 <br /> I hert,�by certily fhul I havo read and ernmined Ihis applice7ion anJ pnow fho samo fo 6o frue and <br /> correcf. 1111 piovisions ollaws and ordinances goveming fh�s typo o/�vork u�ill bo complefed <br /> �ahetherspec�ficd herein ornot Tho granfing ol a pennd does notP resume fo givo authonty fo <br /> violalo orcancel Ure provisions o/nny ofhersfato or/ocallaw regu/aling consfrucfion orlhe <br /> perlarmanco o/consriuclion. That I mn aufhonzed by tha owner ollhisp roper}y fo peAam fho <br /> work Ior rvRich applicafion is mado and I comply with fhe Sfafe Contrac(ars Low 1827 RCW and <br /> 29G.200 W.4C. <br /> � :: �• ' c.��C,..�h� � ` � — 2 a ` Z <br /> �_,,� ,� � _ � <br /> SiqnaWre Date <br />