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�L�CTRICAL R'ERM1T ,4PPLICATION <br /> CITY OF �VERET� PEFtAAIT SERVI�ES <br /> 3200 CEDAR STREE7, EVERL'Tf", WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa,org <br /> APPLICATIONS ARE ACCEPTED fROM 8 AM TO 4 PM <br /> Z S Z� I—.a�v�E <br /> i <br /> PROJ�C7ADDRESS <br /> I "� --A �.�.oSS 2S�io L--aM_RA-R-D ��J� �V�-�.lT $'7� <br /> Owno� MailAddreava . City StalefLip Phone <br /> ^�l � <br /> Tenant MailAddrass Cih State/'Lip Phone <br /> -17p� Gl.�•�Z�'["'p-+L� �d f�' b}[ !�� 7�Jdi"��"'1t.- � �GrO'-cS ��'S `�YSS��� <br /> -� <br /> Eler,incal Contractor �_ _ Mail AdOress.._.. ...._ . . ._ ........��_. __... _. .. .. . .. .. StetefZip -...__--- .. _._ ... Phone._._.. .w <br /> y � <br /> �o�c�P ts a� �-S— .,_,_ � 7 a.oa <br /> State Llcense Number Conirad Price of Work <br /> �v�� -- ��—S(D�rat� ��, }�+'-�.1 f'3���"'ti1� <br /> Proposed Usa of Building � Contact Person (Plan Roview) <br /> '7 S� <br /> Square Fcot�qa(If rasidenitnl new conshuction, remodel or addition) <br /> Dascrlptlon of Worfc to Be Done: -c—P w�r�"'� ��A`+���� �� �'� <br /> �iRr�alhF l`�o�-v f't�i . <br /> i <br /> i <br /> NOTE: WIRING IN NON-DWELLINGS IS f2EQUIRED 70 FEF <br /> I BE IN RACEWAYS, MC OR AC CABLE. ��QO <br /> ! I CITY OF EVER677 L4CAL 3ALE5"PAX CODE IS 3705 <br /> � !heroby certi(y thot 11�ave mad and examined thls epAlication au�l know the same to U�tn�e and <br /> I cr,�ct. �1U piovisions o(laws and ordlnonees qoveminq fhls type ot waik wi/l Ue completed <br /> i �,l;oLhorspec�edhoroinornot. The�rt�nt�npc;apennr/dxsnotpresumetoyiv�authantyfo �/ �O� , ��/' <br /> � v�o!afe or cnnr.el tho nrovisiuns ol any oLher stute or locol lttw reqUfeting conshuchon or the � r <br /> narrormance oi construc6on. That 1 mrt Quthodzed by±fie owner of thls pmperty:o pedom�the <br /> ' irork/or whlr.h applrcaG'on is m+ade end I comp/y wtlh the Stete Con(raclors Law iB.27 RCW and <br /> 296.200 INAC. <br /> �� �P � � ���� � <br /> � <br /> � �ignoturo Dsle ' � <br /> ' I <br /> I __ .__T� �1 <br /> r —� <br />