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! � <br /> � � <br /> ELECTRICAL PERMIT �F�LICATION <br /> CITY OF EVERETT PERMIT SERVIGES <br /> 3200 CEDAR STREE?, EVERETT, WA 98201 3 ,� $'y'j <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org � I��3 �D� <br /> E�" <br /> APPLICATIONS ARE ACCEPTED FR0��1 8 AM TO 4 PM <br /> /03�0 ��ev� YeP� 1,�av STE�$ C-�-�� �/ev�}{ l,�/a q�'.�u�` <br /> PROJECT ADDRESS <br /> �� <br /> OWnCf MadAddress Ciry SlatefZip Phone � <br /> /03?u �v�vPe N WUr ��S-34Nj' °� <br /> ��� �.�{e�wUt;��,ti.l srE� �-� E�ev� �uFl �g��� `�- <br /> Tenant Ma�t AdEress Ciry StatelZip Phone <br /> �e—�����.y� M—ac���1 .�1e�rf �e�J��es, ��'��� �S�UA�eW�L' �-N�NWv�<I 1;J 9Y�� �tas-9�I-�r � <br /> Electncal ConVactor Mail Adtlress Ciry Stale2ip Phone <br /> tNE�'� �sql � �� � l, sU�. � <br /> Slale License Number Contracl Pnce of Work <br /> C DWr-�Pt/C �( I <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(if residenlial new conswction,remodel or addition) <br /> Descriplion of Work to Be Done: ��Q Aa n v1 4�(� / U 0 v I/ e I/���� r�Yt?,�,cUGtn,� <br /> d I T— <br /> '"� c Oo i r l, � <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �� �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily thaf 1 have rcad and examined this applicafion and know the same!o be true and C ( 30 3 — I OS <br /> cnrrect. All provisrons n//aws and ordinanr.es govemmg fhis typr.a/woik will be complefed <br /> whefher specficd hcrein or naL The granfing of a permd does not presume to,qive aufhonty lo <br /> violafe or cancel fhe pmvisions ol any olher state or/ncal law m.gulating construchon or fhe <br /> peAormance ol wnstruc6on. Thaf 1 am autlionzed by the owner o/this properly lo peAorm the <br /> wo�k/or whir,b applicafion is made and I compty with!he Sfale Confrac(ors Law 9827 RCW and <br /> 296.200 WAC. <br /> —�����-. 3 1 s/�oi 3 — <br /> Signatmc Date <br /> �f� — <br />