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O1/�G/2013 TNU 16: �6 PTY m002/002 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C[DAR STREET, [VERGTT,WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org � ..a 5 -�3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM E��.d r -/�3 <br /> y�Z� ��S�� n� +�� <br /> PROJECT ADDRESS <br /> � i `nb�ha� �zIC� ' ��[���;��"�bZ�� �2����� <br /> 0��� � MailAtltlress City Slete/Zip Phonc <br /> cn ��o �J61��� <br /> ��,,,,,�� /� �► <br /> Tenant MaIIAtlGress Cily Slate/Lp Phona <br /> ��Q�i�1�G.r► �I �-���h�c�, 1���� 2n�� 1�ou�i�l�Yr►�Y1 I,�� �21� �D�ulq �1Y�0 <br /> EledricalConlraclor MailAddress City � Smte/Zip Phono <br /> M�Gb.�d1(�:G `�►(� �'1 ��� <br /> late Ucense NumLer Contract Prico of Work <br /> ����+�� <br /> Proposed Use o(Bullding Conlact Person (Plan Review) <br /> Square Foolage Qf residenlial new construclion,remodel or addition) <br /> QescriptionofWorktoBeDone: 1� IUVL l 1 J L�4 �w�'v ��V'� ��� `�" I <br /> �P��� °� � u���<< � l �• � u� . ��� <br /> � �.� � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREDTO �E � <br /> BE IN RACEWAYS, MC OR AC CABLE. C <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �� <br /> 1 hereGy cert,fy lhat I havo read and examined this opplication and know fhe same to be true and -� � �� <br /> correct. All provisions of laivs and ordinances goveming this fypa ol�vork will be completed �I ��� ( - I � , <br /> whofher sFeaTied herern or not. Tl�e granting o!a pemut does not resume to give aufhority to <br /> vio/ate or cancel!ho provisions ol any ofher stafo or localla�v reguPting constacLon or fho <br /> pe rmanco ol consVucf�en. Thaf I am authon<ed by the owner of fhis proporty to peAorm fho <br /> � r !or�rl�ic application is made and I compty with the Stnfo Contractors Lmv 18.27 RCl1'and <br /> .6 200 W -. <br /> � <br /> � q � � �� <br /> Slgnalure Dato <br />