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07-23-2012 9: 06 AM 185644196B8 14252578857 Pg 1/1 <br /> � I <br /> ELECTRICAL PERMIT APPLICATION li <br /> CITY OF EVERETT PERMIT SERVICES <br /> � 3200 CEDAR STREET, EVERETT, WA 98201 I� <br /> � 425-257-8810 - FAX 425-257-8857—W�^�'•everettwa.org � � � L� —I z , <br /> i� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � � �j7_ //Z I <br /> I ,. ,7 J;,, II <br /> i �^ ��:L ��I ..%��� F � � <br /> I PROJECT ADDRESS I <br /> i, -;r-� � �� � ��' .�'� ��e�e��- ������ �I <br /> i �; �� �I�i i <br /> Stete/ZiP YhOne <br /> i �,�e� MeilAddreae �'H � <br /> I <br /> I StetelZlp Pho�a � w <br /> I Tenent Me�lAdtlresa ��°Y . 1�25�3`�-�1 rC� PI <br /> i <br /> I L�.5+.- cls�.. t le�tr'�c �� �t I'- ' �$ ��'�� �� ��^ t.���)U�.i'; (� � �I�'C��> � <br /> � Sta[e1Zi Phone <br /> � ElectfiCelContredo� MailAdCfess Clty P � <br /> i [� � �� � V l: L�� � <br /> E f 5 �:JL � `"�S� D I'� CoMroct Prlce of Work <br /> i 52ate LiCen9e Numhef � <br /> J )� � � ' .'...).l�f� � <br /> I' Proposed Use of Bullding Contect Perso (Plan Review) �� <br /> I . .�,5�j _^-��ct 5 � <br /> " l<�GI �ZS <br /> ' �2c=� SF " � � <br /> � Squere Footege(If residential new con9trvction, remodel or addition) <br /> i <br /> I�I Descnption of Work to 6e Done: � w I �� L� 1� D � �U�/ � I^� 11 -�",�J� < <' I <br /> i <br /> I I <br /> I � <br /> NOTE�. WIRING IN NON-DWELLINGS IS REQUIRED TO FEE � �I <br /> i BE IN RACEWAYS, MC ORAC CABLE. <br /> I C�TY OF EVERETT LOCAL SALES TAX CODE IS J105 I '� I <br /> � 1 hereby certify thaf 1 have rea0 entl examined N�s appllcetlon antl know tne eame to 6e true and � <br /> correcC All provlslons of lewe and orrDnances goveming th�s typa o/woric will be,comp7eted ! <br /> whethe�apecH7ed hereln or nat. The granting o/a permR does not presume to g�ve euthonty to i <br /> � violate or canCel the proNsions ol eny other atafe or loeal law regulating cons2ructlon or the <br /> Ipe�ormance o/consbuetron. Thet 1 am euthorized by the ownerof thls propeRy ro per!orm the Z <br /> 296 200 WAC.apP���etlon is mede and I comply wlth Ihe Steta Contrectors Law 18.27 RCW end �(Z.Cj7' � � , <br /> ' �1 �-'� � Z z_ i <br /> SlgnPt� .� OaIO i <br /> I� —._. . _._-____.'.� _._ ..._ <br /> 1 <br />