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i <br /> � . �1� � 1�� � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425�257-8857-www.everettwa.org a _�(�- 14 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM CI�{D a-I �F C� <br /> 30� �-� ��.< «�� ew 1��a, <br /> PROJECT ADDRE S -.�(�p 3�i8 <br /> �p� L� <br /> �`��C0.� {'(i �^ 3GG /JG�i t .�vl/ �v��crJ GL'� 1�Zo3 <br /> OWnet hlail Aadress City Slale2ip Phone <br /> Tenanl hiail Add�ess Ciiy Slale/ZiD Phone <br /> t-125- l-'�� <br /> �-�M('��mfi���� - � 8� s C- �� c �1�52 <br /> StalefZi Phone <br /> Electrical Contraetor aii Address City P <br /> I�MUJrn H-`-��'�.S � Contrad Price o(WoAc <br /> State License Number <br /> —G�a�r�t�a��o�V� <br /> Proposed Use of E3uilding Contact Pe�On (Plan Review) <br /> Square Foolage pt residential new cunstruclion,remodel or addition) <br /> Descnption af Work to Bc Done: ��,�s � r 1-la� nl �a �' Un C� ��!m�`��� <br /> �t � G,.��o�o� r Llw��� <br /> C �,wr�{ Ta E.�, s 1-i�. G�s�L��� <br /> NOT[: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE �� <br /> BE IN RACEWAYS, MC OR AC CABLE. �� <br /> ✓ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cort�ly fhat 1 havo�ead and examined fhis application and know Na same fo be frue and 1_ I 1 � O L , I I I C� <br /> correcL All provisions o/la�vs and ordmances goveming fhis fype ol work�+ill be complefed ` l"[ `l I <br /> whether specified herem or not The granGng ol a pormd does nol�msume ro give aufhonty fo <br /> violafo or cancel fhe p�ovisions ol any olher sfafe or local law mgu ating construchon or lho <br /> pedormance olconsf�uchon. That 1 am aufhonzed Ay(he ownoro!(his properly fo peAorm fhe <br /> work(or which applica(ion is made and 1 compty�vith Iho State Contrac(ors Law 1827 RCW and <br /> 296.200 WAC. <br /> /'Lt�l�al 2 –z-v'/�� <br /> Signatum Dale <br />