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� <br />� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-E3E' 0- FAX 425-257-A857 - tiwyw everethaa org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�, ae <br />, 2�1�d ��HCM✓D �i�'F• <br />i PROJECT AODRESS <br />Owr.er <br />Idail AtlOrc55 <br />�N�fro /ZF�''rnZS <br />Tenant tdadAedress <br />Cay <br />Cdy <br />SIaICQip <br />StaleZp <br />Phone <br />Phone <br />d�A����i si��✓ c�n/�• lL�"Sl�P1�L�1irF ��F. I✓ SFq�i�e"�_�ij- 9�/0� ?,�G-7E2.o1v0 �I <br />EICC(flCal COtllydGlOr ldad Atldress City SlatelZip Phone <br />', /✓A1ioSC`3iri3 <br />Stale lir,ense Nurnber <br />Proposed Use uf �uilding <br />Squaic Foot, �e (II resideNial new construr.11on, remodel or adddion) <br />� SQ� �/ <br />ConVact Pnce of Wor4 <br />Sff✓F 7�1t�1�3p3��,✓ <br />Contact Person (Plan Rewew) <br />DescriptionalWorkta�r.pone ���C 2. Q�y $/�''CCF" �iiGF /G�umiN�� L�4'}jq. f�6r'�S. <br />--� <br />�jQ (,GFC1�([Qy h/G�K �'*�"i FF/�cJi✓C �'GIr'��I(A{ /N11Q� (,/G G13�FliSIlNS <br />—Y — — -- <br />N07E�. VVIRING IN NON-DWELLINGS IS REOUIRED TO �fEE <br />BF IN RACEWAYS, A1C OR AC C�BLE . �O �� <br />CITY OF EVERETT LOCAL SALES TA%,CODE IS 7705 .-- —_- — <br />I Ireieby cert�ty thaf I havc read and eaamined Ihu app��r.ahon and know fhe same fo be truc and {�" I� I �_ I f� <br />conecf All provrs�ons ol laws anA ord�nances governing Ihis (ype ol work wdl be complefed L I <br />whefher speaficd herein or not. 7he yranpng ol a pernvf does nof vesunrr (o give :�ulhonty �� l <br />wolate or cancel �he provisions o! any o�her s�ate o.locai law regul,�f�ng consfructron nr fhe <br />perlorrnance olconshuclion Thal l am aufhonzed by (he o�t�ner ol flus property fo perlo�m Ihe <br />�vork lor �vhrclr applicat�on rs rnade and 1 comply ndlh the Sfate Contracfors La�r fA 21 RClNanr7 <br />?96100 WAC. / A <br />����}-�Z <br />