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ELECTI�ICAL F'ERIVliT APP�ICATlQN <br /> CITY OF EVERETT PERMIT SL�RVICES <br /> 3200 CEDAR STRE�T, FVERETT, WA 987_01 <br /> 425-257-8810 - FAX 425-257-8857 —v✓ww.everettwa.org � �-�a 6-�2 <br /> APPLICATIONS ARE ACCEPTED FF"cOM 8 NM 1`v�rM L������-I Uk� <br /> � � �,�� L.������ h�� ��� <br /> PROJECT ADDRESS <br /> �E'.a�1'lc��u� � <br /> ��''-� I n�y G��� �,,-c�-c-tt wA ����'/ <br /> Ownef MailAddress Ciry State/Zip Phone <br /> Tenant MailAddress City Stale2ip Phone <br /> Rl'] �G.F^B1�r '-Iz5 z3! <br /> � ` �"� 5�-��,.,��� �K �� z �� �., <br /> �� n���,;vr�i �lec,�-nc. N w � wrt- <br /> EleclricalContraclo� MallAddress �•�ty Stale/Zip Phone <br /> b 1/��t_c� , 9 5'� D� Sc-o �= <br /> S�ale License Number Cortract Price of Work <br /> Propose�e o�ing Contact Person (Plan Reviev�) <br /> - Square Footage Qf residenfial nev�conslruclion,remodel or addition) <br /> Description of Work lo Be Done: E�'--L'-� ��-`� ���'✓ � a-�� �' Y' ��'���`F SJ b ��t✓� <br /> C�re.�,'� l - 2 <br /> � ��.� _ � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQU!RED TO FEE <br /> � <br /> BE IN RACEWAYS, MC OR AC CABLE. � � � <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that I have read and examined fhis applica(ion and know lhe same fo be true and <br /> correcf. A/l provisions of la�vs and ordinances govemmg this type of work will 6e completed <br /> �;hether specified herein ornoL The granting ol a pennd does not resume to give aulhonty to <br /> violate or cancel the provisions of any otherstate orlocal/aw reguP6ng constnicfion orthe <br /> pedormance o(consWction. That I am authonzed by the ownero(this properfy fo perform the <br /> i•�ork for�vhich applicafion is made and I comply�vitfi the State Contractois Latv 18.27 RCW and <br /> 29G.200 WAC. <br /> '�'� (���L��--- _--�-- ` `�� �: � � �= <br /> -- --- <br /> -- <br /> Siqnature �ata <br />