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S6/il '�'2: :. PF.; 9: C5 FAi C25 98B GSO1 Sca-Copy �09�!OJ: <br /> � • <br /> I_ . __ .. . . .__ _ __-_. _ _.__..__—.__' --_--' _ _— —___ ____ _. _._.. <br /> � <br /> � ELECTRICAL PERMlT APPLICATION <br /> I CITY OF EVERETT PERMIT SERVICES I <br /> I 3200 "'EDAR STRFET, [VERETT. LVA 98207 <br /> , 425-257-£3t310 - FAX 425-257-8a57 —���,�s�� everelttva.Gtg <br /> APPUCA710NS ARE ACCHPTED fROM B AM TO 4 PM <br /> i <br /> zg2� <br /> ; '�=�`sr (�.;t�,_, I �i. �, <br /> I PROJEC7 ADDRE�SS <br /> � i '-i(ili ! ��' �� - .� �. � ��� �! lt } - i -c � ' <br /> �,�i'i�f.Yl 1/(. � l (�l.lr .iil'i._(� �I >L•y1 � fC'..i'11_i_>:�� �.�� � �� i � - 1.1'i/Ji { (,:i���l <br /> OvmOt idaiiAddress C�ty State/2�p Phone <br /> i ��i6GYt �j(f/ 1dr �� ���I �I��i.' � l�l � �� U ( { � li:,Y� �/���l.-l/.' � �IJJ��)I�I � V�.��1 <br /> 'I Tenanl fdaaAOdres Cdy SlalelDp Phone <br /> i <br /> � (� � ( <br /> �i il � � �-Y.:� .jfll(. � �'((,..li iO`il l. �/CI1�(.. �''l':I �:>.�-i.l��,-� �'_il� ���:)ll�� � � ��.� 'J�l�t�. � (;�J i <br /> iEiectncalContractor M2dA00res5 CAy Slale2ip Phone <br /> � � - � � q � i.'r C. ;� <br /> /� t. l. I l: '�t/: � '7(�(.) I� , . � / / <br /> � State Llcense Number Contract Pnce ol VJork <br /> � �ornme,�ia � 1� , , �,-: ) i;,, , ,: ��. � ��: <br /> i �ioposea Use c�Budmn� Co�tact Person (Plan Rev�evr) <br /> ISquarc Foolage pf residcnUat new conslrudion,remodel or adtlition) <br /> DescnptionolWoikto6eDrne: ���'��C1V-(. ( •�� � '1�� �>I ,1 �.; � �. �,� IYIi -�' Yl. �\ <br /> i , <br /> I NOTE: WIRING IN NOIJ-DWELLINGS IS REOUIRED t0 f[t <br /> E3E IN RACEWAYS,MC Oi2 AC CABLE. ���� <br /> I CITY OF EV[RETT LOCAL SAlES ?AX CODE IS�105 .-- <br /> I hereby ce�Aly that I havo revd and exsmined(h�s apphcalion anA kno�a:he same�o be lrue and r�^� O C I�� <br /> conecf. All p�ovis��ns ol laws and erdmances govrmmg 1h�s fype ol work w�U be ComplefCd � �� p <br /> whelher specrhod herein o�nof. The granGng oI a permR does no!presume fo give aulhonly b <br /> violafe oi rancel Ihe provisions ol any ollrer slafe or 1oc31la�v regmatmry Con5liucLon or�ho <br /> O�311J/lir] CO OI CJ/ISl�UCLO/1 ThA(I aM AtlfhJniOU Ay Ih9 uwner o�Ihis p�opeAy fo peAorm!he <br /> �vprk!ur�h�ch'applica�on rs rr7ade,and 1 comply w��h!hc Slale Conlracfor;Law 18 27 RCIY and <br /> 296 20/�VcA i / � <br /> i f / <br /> J� �`i` i i; � �r 1 / <br /> � /✓ � ,.. �i A..� �>�i �.s ��� �� ��� .. � �(�- <br /> � i7 S;gnalvre ' Date <br /> L�/__—_____._ <br />