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� � <br /> ELECTRlCAL PERN!!T e4P'PLlC�.T'��N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982J1 <br /> 425-257•8810 - FAX 425-257-8857 —www.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � � � �Q ��a' <br /> c- �ai � � ��-6 <br /> l s�� �7� , u/� <br /> PROJECT ADDRESS <br /> W (l-�� � _ � � i�l� ��J ���'�d� <br /> Ov.�ner ��AailAJd�ess � City State2�p Phone <br /> Ten�nl b7aJ a ress C�D/ �/Q� Siatdl�p Phone <br /> S�t�� _ _ e��._—1�`����S��l� CLI�' -�&�3 3,60-�=� �S� <br /> ElectricelCoMraetor � .�.IAddress C�ly SIatMLp Phone <br /> S��►��.G,�� g � � Sad � <br /> Slale Li�ense Number Contract Price of Work <br /> Proposed Use of 8wlding Contar.l Person (Plan RevievQ <br /> ----�-- --� - - �� - -----. <br /> Square Footage (I(residential nr.v�construd�on, ren ;del or adddion) <br /> Descriplion of U'lork t_ (3e.�one� . --- • - ---� -�- - --- . - f'L��M — ------------- <br /> -- � ----- - � --- <br /> NOTE WIRING IN NON-DW[LLINGS IS R[�UIREU TO FE[ 1 <br /> DE W RACf_WAYS, MC OR AC CADLG . I <br /> CITY OF EVERETT LOCAL SAIES TA%CODE IS 3105 --- — � <br /> I hereby cerir/y fhat 1 have reao �nd exarnined this apphcalion and knovi fhe samr, fo he Irur. �nd <br /> correcf. AU piovision:ol la�.vs ar,d ordviances yovr,rning Ihis type al work w�ll be r.arnplr.lr.d � ( 2 ('—��6 <br /> whefhr.r spec�hed he�em ornof. Ihe yfJIlGllq OI d(1CRIIII(lUn5I10( ur.sume fo yivn�ufhnntylo <br /> violate or canccl fhe provisions ol any ofher slafe orlocallaw�egula�ing conslrucGon or Nie <br /> pci/nnnanr.c o/consfivr.hon. Tfuif 1 am�ulho�ited Dy fhr, o�vncr ol Ihisp ropeRy lo peAonn fhn <br /> �. work!or v�hich applir.�fion i;made and I r.nnrply vnihlhe Slafe Conlrac(ors l.aiv 1B 27�ZC W r�nd <br /> 296 200 W <br /> � <br /> � 11�'�/y�a---- /�_���_/� --- — <br /> S��nal c I)a'.� <br />