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__ - ------ ----� <br /> �LECTRICAL PERMIT aPPLiCATI�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> � 425-257-8810 - FAX 425-257-8857 -www.everettwa.org � `�� _� 3 <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM ��� �D�.-Gb� <br /> i I <br /> I <br /> ' ��,�5 Jc�Ks�r � ��cr�-�- l,�f}- ��� �3 <br /> PROJECT ADDRESS <br /> � 11�'U�)Il� 1 ��i nL' �I I `1 f�/ V�G SL ��f(L'TT WA I b rJ� (�/ — <br /> Ovmer N�ail Address ��Y <br /> Slatc2ip PhO� <br /> �� �✓ � �� State2ip Phonc <br /> ' Tenant rvlail Address <br /> �v� 0W�, ' <br /> '�, Electncal Contractor <br /> tdail Address City State2ip Phonc <br /> N� .��a�. �, <br /> ontract f'nce of Work <br /> � State License Number ,,/�I <br /> ��� / /^ ! G�U <br /> / <br /> i ��i�t,£-� 't.'G � /� ,...� <br /> � Proposed Use of Building Contact Person (Plan Review) <br /> �� 5�e P�tage(If residenUal new construction.remodel or additlon) <br /> I �r (I L<,. Ci� /��,_sT__��`�zs �' sc�;�c��es <br /> Description of Work to Be Done�. /1 5 r � <br /> NOTE WIRING IN NGN-DWELLINGS IS REOUIRED TO FEE <br /> BF IN RACEWAYS, MC OR AC CABLE. � �U <br /> � `7 "� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby ceddy fhet 1 heve ieed end exammed U:is epp6cetmn end kno�v fhe seme to be We and �/�r z ,{ � n <br /> wrrect. All provisions olle�vs end ordinences govemmg this type ot�vork wdl be complefed r�'`� I J�`l�–O`/ � <br /> �Iwhefher specdied herein or not ,The grantmg ola permd daes nof resume fo grve eu'honty to <br /> v�olete or cencel the rovisions of eny ofher stafe or locel lew rec�uPhng constiuctmn or tl;e <br /> pedormence ol cons�iu:hoa Thet I em euthonzed by fhe o�rner o/fhis property fo perform the <br /> Iwork/or which application is mede end I comply with fhe Sfate Contrectors Lew 1fl27 P,GW end <br /> 296 200 WAC. <br /> ' �l 2 �y � 3 <br /> � � <br /> I ����ti « <br /> s�y wrc <br />