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ELECTiZICAL PERMIT APPLICATION <br />CITY OF EV�RETT PERMIT SERVICES <br />3200 C[DAR STREET, EVERETT, WA 982U1 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />L' <br />; y�a sc �v�r�c--rr �r ��� �;� , <br />PROJECT ADDRESS <br />Owner <br />Maii Address <br />Ciry <br />3 -�-�3 <br />CI3v3--0�� <br />Stnlerzip Phone <br />�i1(�r�i L' i�C`i lYU2- S� EU�eki�' iit�fu G�vt �' EurEE7T Ivr1- ct�Jof� pnonc <br />Tenant � tAail Addfess C�ry State/Zip a� <br />n.. .,. � n..., ,. ii�. .... �/ c i r�' i?(�4. /7n�~/� !iL . l.�' HF�N�W'-' wn- F�o3y 3� � <br />Electricel Contracto� �dsn A�faress <br />G�ttiEC�t °v�P* <br />Slate License Numbe� <br />Proposed Use of Building <br />Square Footape pf residential ne•.v conslNction, remodei or edditioN <br />Clry <br />Slale2ip Phon2 <br />z, 3 o c� . s-o <br />Contrnct Pnce of Work <br />�'ft�P OC.��P��v <br />Contact Person (Plen Review) <br />� �iSU � �' �o (� <br />Description of Work to 8e qona: L-�'n%/Y�.u-A� ( c'�"770,1� - <br />D � ti1 Z' d F �92(..' /i-�1.D ?�L.E �i� N�. G eS.s ?�t /'1 ti �° — <br />�EcicCCS _ <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO `EE __ <br />E3E IN RACEWAYS, MC OR AC CABLE. `���' <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby certify �hot ! hove road and ex,amined this application and know tho same to bo (nre and I <br />co��act. All pravisions ollaws and ordmnnces goveminp fh�s rypo a� work wiU be complefed � I��.,-� � � <br />whethor spoafeU horoin or noL iho granting o� e permd does not prnsume to give authonty fo .,-- J i � <br />vioiato or canc�al tho provrsions ol any o[her stato or /ocal /aw rogulatinp consWchon or the . <br />peRormance oI construc6on. 7haf I am authonzed, by the o�mer af this properYy ro pedorm tho <br />work for which app6catlon is made and I comply wRh the State Contracfors Low 1Q.27 RCW and <br />3-i-�3 <br />z�/ae 3�dd 3�3airi oiat�soa zsro6hv��r.r ��n:�::T �,:tr�,,is,.i.�� <br />