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i <br /> ELECTN�lCAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CI=DAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �/IV/�Z <br /> (,�/Zd S--O �2S <br /> 2 � C� � C� l.(�-vY <br /> PROJECT ADDRESS <br /> V t�S-�- .S3 <br /> ��pw�(�S �`� Ao��AN �v�?� w�R ��Zc� l 6� <br /> OWnef MellAddress City SlatelZip Phone <br /> Tenant MaiiAddress City Slale2ip Phone <br /> ���� � y?_5-3�� <br /> �7h� �\F��ILI�,.'G� � �1��� Phone / <br /> ElectricalContractor MailAddress C�ty Stata�Zip <br /> vn��G�� �� 1� � �3JC, r <br /> Slate License Number Conlract Price of Work <br /> F='�-�-�� _� �Sk�v � <br /> Proposed Use of B�ilding Contact Person (Plan Review) <br /> Square Footage(If residential new conslruction, remodel or addilion) <br /> Description of Work ta Be Done: PI�2T ��� ��� �'����rlN�" �� T <br /> l 5-r ��a.-�2 �w J R��N; t_r Cr?-�T�S I N w►W�� I <br /> p�S�c� �1 �oo m /-��1 O '1 - ���pqc.� O�a-s�f� La c�- <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � � I � B� <br /> CITY OF EVERETT LCCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that 1 have read and examined this applicafion and kno�v fhe same to be frue and C <br /> correcf. All pmvisions ollaws and ordinances goveming fhis type o(work wdl6e completed �I Z� J' � <br /> whetherspeci�ed herein ornot The granfing oI a permd does notp resume fo give authonty to <br /> violafe orcancel the provisions oI anv oth�rsfate orlocallaw regulating construction or fhe <br /> peAormanco ol conslruction. That 1 i�m euthonzed 6y fhe owner of fh�s�roperty fo pedorm fhe <br /> work/or whi plication is made and 1 comply wifh the State Contractors Lo�v 18.27 RCW and <br /> 296.200 W C. <br /> �' S��j Z <br /> Signa ur ate <br /> - <br />