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� ~ <br /> ELECTRICAL PEF�MIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 96201 � _ 2 3 --I�Z <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> ��12a�-45'a] <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br /> �0� � EJe �c � <br /> PROJECT ADDRE <br /> OWner 6!ailAddress Ciry State(Lip Phone <br /> T��.cKSOV�S �� � �al C`VP��Q1� a �ilQ� la �., �-SU 1 � <br /> Tenant A9ail Add� City Stat 'p Phone � <br /> �5 r�d�� 3�t� �e W ���,w�,� �� ���� ��-9�1 -35� <br /> Electricai ContraClof Mail Address Ciry Statel7Jp Phone <br /> F1JF12GrNIS �S'� .� �o�' <br /> Stale License Number Conlract Price of Work <br /> �filbG(rd �(L�.A�- <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(I(residenGal new consW cGon,remodel or addition) <br /> Descriplion of Work to Be Done: �'f V1'�"/� /�ti1 e0�'�C ��P0.R" C.,Olil�7�/JI IPI( �'1 s`I�l II G��D� <br /> (�01.���� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �� rjO <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi/y that 1 have read and examined this application and know the same to ba true and �' �O� � <br /> correcL All provisions o/laws and ordinances goveming this type of work will6e completed ��� <br /> whether speci�ed herein or noL The granting of a permn does not presume to give aufhonty to <br /> violate oroancel the provisions o/any ofherstate nrfocallawiegulating consGvction orthe <br /> pedormance olconstruclion. Thaf 1 am authonzetl Sy the owner of fhis property to pedorm the <br /> work lor which app/ication is made and I compty wifh il:e State Contractors Lavi 18.27 RCW and <br /> 296.200 WAC. <br /> �. i ��i3 .Z <br /> �� L� <br /> � Ignature Oate <br />