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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 96201 �- ,�9-i3 <br /> 425-257-8610 - FAX 425-257-8857 -www.everettwa.org �-� 30/-/6 7� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> Z.�U � C OC� (5`'�' T��iC �VL.'YE.�� c� � Z� � <br /> PROJECTADDRESS <br /> I�`-1 �3qn/�- sR�'� <br /> Ownef MailAddress City State/Zip Phone <br /> j��-� �Al.i1l. $V�3,�'i�% <br /> Tenant Mai�Addrees City Slate/Zip Phone <br /> Lav)11�-�77v' <br /> �� r2cus�lc...=c_ E�-'�'.�t-etc._ p.o_ �3ox 2� �0 ,,,,o,x,n�uc� ,,�- 9�o�z <br /> EleclricalContractor MailAddress City State2ip Phone <br /> � ! ZUJ -- <br /> ��� �� 6C i `� S3 �w � <br /> State License Number Contract Price ef Work <br /> ('�MM A[-�6-+ �-tv-i..��rr- <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> , �2Jv� 7l ��v`IJ <br /> �L�7✓7cOL�L iUil <br /> Square Footage(ii residenliai new construclion,remodel or addition) <br /> Description oi Work to 8e Done: D�s�N "'�� ��� ��� • ��^� � ��r <br /> �� <br /> G�P1,v T 7� A 3'J A-w�.� G�2u;��- !�L`= c-o.vn.c=�l� ��i1—�^il <br /> i <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RAC[WAYS, MC OR AC CABLE. ��-/ �� <br /> 7 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby certily that 1 have mad and examined this applicafion end kno�v tbo same to be fnre and � /�D r ^ ��� <br /> conecf. All prnvisions o/laws and ordinances govenung tbs fype o/ivork will be completed � � <br /> �•:hefher specd�ed hcrrin ornoL The g�antiny o!a pennd does not resume to give aufhonty fo <br /> violafe nrcancel the �iuvisions olany otherstale orlocal la�v reguPting conshucLon or fhe <br /> peifonnance o/cons�nic6on. That 1 am aufhorized by Ihe ownero(flus properiy to perlonn fhe <br /> a�ork lor which app6cation is made and 1 compty wilh the State Confracfors Lan� 18.27 RCW and <br /> 296200 W,4C. <br /> :,%� /l' '-�-4'--__`. �/Z � � 3 <br /> —"= s(gnature Dale <br />