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i � <br />� -- - - - --- ---------- - - --- <br /> , <br /> � ELE�TRICAL PERMIT APPLICATION <br /> CITY QF EyFR�TT P�RMIT S�RVICES <br /> 3200 CEDAR STREET, EVERETT, �VA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —�nn�✓w evereUv✓a org � �.�3_�z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C�I ZO���r <br /> I <br /> ! i' 9 / 6 , � lh� <br /> I PROJECT ADDRESS Cf�` �.- 2Y y�0�1 �'I <br /> ( ' LC � �� a � (�A ���wAV #� 190 � �vQ� e ��f dti' f� �7 �ao � <br /> I C'v✓nCr Pda�lAddress � C�fy SlaterLp Phone <br /> Tenant MaAAtltlress LAy SlatelZ�p Phone <br /> �w�v, <br /> [Icdncal Coniracior �.7a�lAddress Cny State2ip Pnone <br /> Slale License PJumber Conlr+d�ce o(�rk <br /> -rr�-plex �',�k �e►„�c-vi�/ — <br /> Proposed se o �uddmg Contacl Person (Plan Rev�ew) <br /> Square Foo�age(II residential neev construdwn, mmodel or add�lion) '', <br /> Description of Work to De Oone �E,Q/_y C_L'_���L fi� � C e� l 5 e r� ��e e , /'?e fL�� �_� <br /> ��e 1�o y f—G�.tti�_�1�',Pi — I <br />, — ---– � U <br /> NOTE WIRING IN NON-DWELLINGS IS R[OUIRED TO F« <br /> f3E IN RAC[WAYS, MC OR AC CAOLL= . �,,._,� <br /> ��� <br /> C17Y OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> 1 Irerc6y ceR�fy that I have read and examined this applica�ion and know Ihe same lo be fiue and r� ��� _ O'v I <br /> CorTecL A/l provisions ol/aws and oniinanrns govemmg fhis type o/wo�k w�ll be complefed Ll'U� <br /> r�hether specr/ied herein or noL Tlre granfing ol a permd does nof resume to give aufhonty�o <br /> v�olnfe or cancel the provi;ions ol a��y c(her sfafe orlocal l��v myuPfing consNur.lion or(hr, � <br /> pedomtance o/conslruc6on ihaf!a.m avfhonzed Gy Ibe ov.•rier ol this pioperfy lo pedonn Ihe <br /> u�orN lor which application�s made and I comply H�ith the Sta(e Conliactors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �����'="�— ��/ ��( a` <br /> SigR`alui_ Dale <br />