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�J �, Z f <br />ELECTRIC,�L P�RMIT APPLICATION <br />CITY OF E`f�R�TT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />AFPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />C�^e-�q,�� �t;c.�, <br />pROJECTADDRESS <br />0 2q S <br />('�,,,�k.-5 53�5 sw n�.�aoows � i� Os�� <br />EVeT�I ��'� U-e <br />Tenanl <br />Electrical Contractor <br />hlail Address <br />City <br />i,ly`1 .�rtilM.5r1'�c.� F%W� si�IK.r�irr <br />Mail Address <br />Ciry <br />� �a�-�z <br />C 1207-1�{0 <br />Ur, �17o3i (so3)6o3�-�00 <br />Slate2ip <br />w�J 3o�i�V <br />SlatelZip <br />Phone <br />��3 �7a7 �s�� <br />Phone <br />�a�� s� s� "� r��o�;��-�r�.���� �� 9�uY3 �-a���� 7�.3� <br />h7ail Address <br />hlv�F��-9�� �� �rr{�H:�') <br />Slale License Number <br />�F�.ss �l�til� <br />Proposed Use of Building <br />Square Footage Qf residential ne��i construcfion, remodel or addilion) <br />i <br />,/,�F,cGc.� 1lR�v �. � *� <br />Description of Work lo Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQI�IRL-D TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />Ci�y <br />StatelZip <br />`,�,��(7r7(7,Q� <br />Contract Price of Work <br />� LD �{%c� <br />Conlact Person (Plan Review) <br />o � V ,-iGn-S •' /-� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereDy certily thaf 1 have read and exarnined lhis ap��licafion and!<now !he same lo he lrue and <br />correct. All piovisions of la�vs and ordinances govenung (his lype of ���crk c✓dl 6e, completed <br />�vhetherspealied herein ornot. The gran(ing o(a pemut does notp resume fo yive aidhonty fo <br />viola(e orcancel fhe prov�sions of any ofherslate orlocalla�v regulating consWc6on or (he <br />peAormance of conslrucfion. Tl� t 1 am authorized Uy (he o�vneru(thisp �operly ta pedomi the <br />�vori< lor which application is ma e and 1 compty �vilh (he Sfate Cantrac(ors Law 18.27 RCW and <br />29G.�OC WAC. <br />� �.�-- 7�L � �j�- <br />rnone <br />� N(/,•7`C ; 9SJ��t. j'. <br />FEE <br />��2u�- -�yu <br />