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� - -- -- -- - <br /> ELECTRICAL PERMIT APP��,IGATION <br /> CITY OF EVERETT PERMIT SERVI��ES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 2 vl��? <br /> 425-257-8810 - FAX 425-257-8857 —�vww.everettwa.org J J <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �13�3�'I� <br /> /}�r\ R 1tJ i2, � �I�,� /11t1 �-�C'� <br /> � 1 3 ► r rr�a(�� N t� v ��w �i�C'� I%.u�c d��r ,wv`�— <br /> PROJECTADDRESS <br /> ��r;_3 �� � ISS <br /> �� � ^ � l1 <br /> Owner Mail Address City SlatelZip Phone <br /> � �/� f �'� <br /> M�`�.�� li �� �L'-V`.'� Iv ���1���- � <br /> Tenanl Mail Address Ciry SlalelZip Phone <br /> '� V.-lUl1"1��� ' 1 � /i 'r�f�C �' ' �0 ��7Z l. � ��1��(�- UJ�'� �'�f'3S �� 7�321327� <br /> �l,l"� , , G � � <br /> Elecirical Conlractor <br /> A7ailAddress City StalelZip Phone <br /> > c 'IS D , OC� <br /> � ��"<<. �-� -�� ��� t l L r� <br /> State License Number ConUact Price o(Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Square Footage Qf residen�ial new conslruction. �emodel or addition) <br /> Descrip�ion of Work tu Be Done: <br /> L I�nf{ f (I�1C'.� IGti�i 1��� �� �� � r� <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CADLE. / �c_ C,`1 <br /> lf� -' � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � I He�eby cmti(y fliaf 1 have read and examined fhis applicafion and kno�v fhe same to be tnie and <br /> canect All provisions o/Imvs and ordinances govemu�g fhis type ol u�oik will be completed <br /> whether specilied herein or noL 7he granfing aI u penmt does not resume to give au(honty fo � � �)C'J � � f � <br /> violate or cancel(he provisions olany othersfafe orlocallaw rrguPting consfnicfion or fhe <br /> pedomiance o/constnichon. That 1 am aidhorized by fhe o�vner o/thisp r�perty fo pedonn fhe <br /> woik/or which applicafion is made and 1 cornpty with fhe Sfafe Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> r <br /> '=;� k� �,,,, ; � � IP� - <br /> Signature Dale <br /> f . __ .. _ __- ----------- <br /> r. <br />