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I <br /> �� <br /> ELECTRI�AL PERIVIIT APPLICAT'ION <br /> CITY OF E�/ERETT PERMIT �EKVICES <br /> I 3200 CEDAR STREET, EVERETT, WA 98201 <br /> I 425-257 8810 - Fr',X 425-257-8857 --www.everettwa.org <br /> APPLICATIONS ARE.4CCEPTED FROM S AM TO 4 PM <br /> ;_j II � i"kL1(_j�vv Pr� , C.�J��� <br /> PR4JECT ADDRESS <br /> � <br /> �/�t, r�n ru�v o <br /> Owner Mail Address Gry State/Zip Phone <br /> Tenanl Mail Address C�ty StatelZip Phone <br /> Hu,:S� i 425�239 <br /> `��r¢ � aL sc i�E �c:H�S `3 '1 Pi. 5� �R��E -i%-G�Fn:, VJI't ��ZS�' oG,r 3 <br /> Eleclrical CoNraclor Mail Address C�ry State2p Phone <br /> I I7��✓v� � <br /> lll� t-4uU���'ii 2. <.iC. <br /> Stale License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> C; SC�. ;_� <br /> ISquare Footage (If residenlial nev✓consiruction, remodel or addition) <br /> ' ��[.�4�k_ i 27 /ti Png 5'i:2 V��--� P f'cYv�l_. <br /> i Oescriplion of Wor�,to�e Done: ���V <br /> i <br /> i <br /> I <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> RE IN RACEWA'fS, MC OR AC CABLE . � G� ' � I <br /> � I � <br /> I <br /> ��. CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br /> - I lrereby certify Ihat I I�ave read and examined(his applicnlion and know the same to be fn�e and � �� � I +��� <br /> � correct All prnvisions o(la�vs and ordinances govemmg fhis type ol�voik�vil!be completed <br /> �� whether speci6ed herein ornoL The granfiny ola permd does notp reswne to give aufhonty lo <br /> ' violafe or cancel(he p�ovisions o/any otl�er sfale orlocal lard regulating consfnicGon or fhe <br /> peilomtance o(cons(ruction. That 1 arn authorized by 16e o�vncrolfh�s property to pa�lomt the <br /> i �vork(or which application is made and 1 comply with tlie Stafe Conlracfors La�v 7827 RCW and <br /> 2.96.200 WAC. <br /> j <br /> //'���.���'���--- ��-(� / � <br /> � Signature Date <br /> I <br />