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i---- - --- -. <br /> ELECTRICAL. �ERMIT APPLIC�4TION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, GVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everattwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /D!/ 5 �V<<2G2<<<C�✓ ��� <br /> PROJECT ADDRESS <br /> i -r�Z��,,,�,C �iw���-,y ��.2c✓A �wF.'•u ,n145✓�✓Rn /�F1t��ac cvA �t6'�`F7 zP�ne33 <br /> Owner <br /> Ciail Address Ciry StatelZip <br /> oFF�c�- v�P�� ��'�is �tt�26L�:✓ c.v/tY Ev<<+c�� u/� 98yei! �zs- r�3-a is" <br /> Tenant Mail Address City <br /> Stale2ip Phone <br /> / <br /> L���.�-�� �rc� �: LC����c i v 4'z S z 3a-tti ,�v F_S�` /19.h�/� �k ';�e=w'r ���c� �f <br /> Stale2�p � Phone <br /> Elec!ricalConirac�or MailAddress �'�Y -{LS--�'=.7-`/Z/f <br /> C1 �,55 b � zza � <br /> �'�'�� `� e f Contracl Price of Work <br /> State License Number <br /> ,�u\�t.n Wo4.2'�V-�117 <br /> !�L�%f? /L <br /> Proposed Use of duilding Contact Person (Plan RevievQ <br /> Square Footage(If residenlial new construction, remodel or addition) <br /> Description of Work to Be Done: <br /> �t/r�2�NC; qi,iD GanfN�� c ,—Ionl O� C�fIRaL SlG� <br /> � ExiSTin/ Gilzcu.� <br /> I <br /> I NOTE: WIRING IN NON-DWEL�INGS IS REQUIRED TO FEE <br /> � BE IN RACEWA�'S, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SA�ES TAX CODE IS 3105 <br /> 1 hereby cerii(y that I have read and examined this application and know the same to be fn.e and L �Z.u`� � 3� <br /> co�rect. All provisions of laws and ordmancas goveming this type ol work wdl Ue,cornpleted <br /> I �vhetherspeci(ed herein orno!. The granfing o/a pennd does not resume to give authonty to <br /> violale or cancel the prowsions of any other state orlocal la�v reguPhng construction or the <br /> pedomiance of consWction. �hat 1 am aulhonzed by fhe owner of this property fo pedomi the <br /> wod<(or which application is made and I comply with lhc State Contraclors Law 18.27 RCW and <br /> 296.2 �� <br /> � � <br /> — 7- z �, a�('i <br /> ignaW re Date <br /> Fa� �l T, � <br /> �--- ------------ ---- --- <br /> ----- <br />