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ELECTRICAL P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA d8201 �� �a9 •—�z <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org L�.L�1 _� � cj <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � <br /> J 3 u� �t,Q,c � �� �:.ulC �je�c �f u+1• � <br /> PROJECTADDRESS <br /> SL /1/lif,1 '�'hc l��t!!r '!�i ; 4u.�r 3'f s�'OG�r� (.�/.� �4��t ' - SS"-3i3o <br /> Owner <br /> MailAddress City Slale/Lp Phone <br /> L /Lf ,�� .tr� )�� ,ucT,c s C�.�, k ��tc 4 C��' ' �.J�f- 1�Sz�3 f�1a"-3��=s'ss <br /> Ciry SlatelZip Phone <br /> Tenanl Mail Address , <br /> <.',f-t�.� ElP f4'J� �o��c �gL1 Sa /w,�.rak GJ�f 9aa�� �f2�=.3.15'-/fs <br /> Eleclrical CoNractor tdailAddress <br /> City SlalelZip Phone <br /> o� <br /> /�' Z�� — <br /> ,�.SS�:'C.C� i7 c��wC.. ContractP eotWork <br /> Stale License Number <br /> (' � <br /> r ��,- '�" �fi°"�h`�° . Contact Person (Plan Review) <br /> Proposed Use of Building <br /> Square Footage(If residential ne�v conslruction, remodel or addition) <br />-, . ,f �h�� ls r ��-� ,d�,� �.. t/ <br /> � Descriplion of Work lo Be Done: c J ti� � � <br /> � � } ,,.� .�e...i Z =�' �-l�a •c — G��i.� s,�:�.�., v4 �`t��� <br /> I < < — lg � <br /> FEE <br /> NOTE: BERN RAC WAYS MC R AC CAB�UIRED TO � �� � �_ <br /> i <br /> � CITY OF EVERFTT LOCAL SALES TAX CODE IS 3105 <br /> 1 he�eby certify thaf I h�rve read and examined lhis applicafion and know the same fo be tnie and <br /> correcL All pmvisions o/la�vs and ordinances govemmc�fhis type o(n-ork�vill be complefed <br /> �vhetherspeci6ed herein ornoL The granfing o(a pennd does not resume ro give au�honty to <br /> violate or cancel fhe provisions o(any otherstafe orfocal/a�v reguPfing ennst�ucticn or Ihe <br /> pedomiance o(construction. That 1 arn atdhorized by(he ormero((his propeRy to pedonn(he <br /> u�ork for�•:hich applica6on is made and 1 compty�vith the Sfafo Confrac(ors La�v 1827 RCW and <br /> 296.200 WAC. <br /> �//Z CL <br /> 1�����.-� �3a "� <br /> I —�iynature <br />