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ELECTRIG�`.L F'ERMIT APPLICATION <br /> CITY OF EVERI��'TT PEF�MIT SERVICES �_g_�z <br /> 3200 CEDAR SIREET, EVERETf, WA 98201 �1.za(�-O�v� <br /> 425-257-E810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICA710NS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � � C %.: �-r's �...i 1 v'.€li <br /> � , c' �� / <br /> PROJECT ADDRESS <br /> � r � �� ���� � �^�A y��a I <br /> �,��� <br /> Owner ldeilAddress City State/Zip Phone <br /> !f / �✓ �� T��'n't`S ��i � �i ftsn, � Iv ',�'�/( 4t�rr7`7 /v/F y� -%`� <br /> Tenanl MailAddress Gty StalerLip Phone <br /> /���� .57; t� �/i� ���z,�- /C�// �,'I�v� S�'�L� ��'r�cf/ Gr.�A i�Sz�� =f 7 5=y S"3-`�'S`r�7 <br /> EIeC�ticalCoNraClor MailAddress City SlatelZip Fhone <br /> �����r •- c�7, - � , I�?ap« .�rt— <br /> � S�- i � f � �. <br /> Stale License Number Contract Price of Work <br /> Proposed Use of Building Contacl Person �Plan Review) <br /> Square Footage Qf residential new construction, remodel or addition) <br />-. <br /> Description of Work to Be Done: /�i� ��/ ���'��7��'� '��` � � �' ' ^ cr� �`� l�`� <br /> I �Y ! �I) �r� � fi /o .��kl� ��{� /f(,t�-flr,�fs ��Sn r'i n/1C' �-SL' � 7P� <br /> i ,,;oc� /l��>"�I� 5 �i� �'/f< f «/ L'� ��s�5 �C 7 5�1�(�f� f,�+�S �i�•-r �/� <br /> NOTE: VUIRING IN NON-DWELLINGS IS REQUIRED TO FEE � <br /> I� 6E IN RACEWAYS, MC OR AC CABLE. � (_� <br /> � �C — <br /> I� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceAily fhat!have read and exmnined this applicafion and know the snme fo be fnie and �1 ZO ��Q S � <br /> conecl. All provisions ollaers and ordinances govemmg this typo o(�sork will be complefed <br /> � whether speci(ed herein or not Tho gn<nhn�o/a pennd does not presume to give au(honty fo <br /> , violate or cancel fhe provisions o/any othersfafe orlocal faw�e9u/ating consfnicfion or the <br /> � pedorrnance o(constn�cfion. That 1 am aufhonzed by Ihe ownerol this property fo pedomi fhe <br /> work ior which applicntion is mado and 1 compty with the Sfate Confractors L���v 18.27 RCW and <br /> 296.200 WAC. <br /> ;? j�/ <br /> �'� .�t� ��� ���� Z <br /> Signature Date <br />