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� <br />� <br />ELECTRiCAL PERMIT APPLICATION <br />�ITY (JF �V�RETT P�RMIT SERVICES <br />3200 C[DAR STREET, GVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 – www.everettwa.org <br />(0—DI —lZ <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � I'ZI�""�� <br />�3Z /'��'7�..��� i/���P <br />�de� � r,.�n. �Zv � <br />PROJECT ADDRESS <br />-� p n UZs' <br />�,�,' I Lri —1�,�ocQ �to /.3�Z MClpuc1c11 4lP C�J�Y'��_ �jift `�g�� <br />Owner <br />— �/� - <br />ienant <br />�X-\1' <br />Eleclrical Contraclor <br />Stala License Nurnber <br />f�la�l Atldress <br />�utad Address <br />Mad Address <br />�eSS;c��e�-c� _ <br />Proposed Use of fiuJ�ling <br />Square Footage (If resiJentiul nev� conslruclion, remodcl or addition) <br />Gty <br />Ciiy <br />Cily <br />Slaie/Zip Phane <br />SlatelZip Phane <br />StatclZip <br />Coniract Price ot �Vork <br />Contact Person (Plan Review) <br />Phone <br />Descriplian of Work lo f3e IJone� ��'��CR_(� �Ay��_ '�Cl ��lta ��e,_�n�Q�__�GOO l�.•^`� . <br />NOTG WIRING IN NON DWELLINGS IS REQUIRED TO FEE <br />B� IN RACFWnYS, �v1C Oft nC CADLF . --7� (� <br />� <br />CITY OF EVERETT LOCl�I SALES TAX CODE IS 3105 --�-- ------ <br />I hc« �by cerfily thal I have ro:id and r.x�umned!l�is applir.afion andlrnow Ihr. samc to he l�uc and y�O� <br />coner.f. NI piovisions ollatvs :md orJin:inces go�. ^minq Ihis fypi� o/ n�o�k taill he complefed � j 21 �— IJ <br />�vhelhr.r speaGcd herein nrnaL !he yronhny o/:t pcund Joes nat resunrr. fo'give aulhonty to � <br />�•iola(e or cr�ncr.'the pravisions o/ any o(lier sfafe ur/ucal laiv m.guPlin,ry consfrucfion or flie <br />�;r.r{�mrance ol consfnicfion. That I am aufhonzed 5y fhe owner ol (his /�roperty (o perlonn fhe <br />n�or4lor whrr.h a��rcaron �s �r�a�ic and i compty witrr nc� Slatr• Con6ac(ors Law lfl 27 HCNI and <br />296.200 W�1 C <br />. ? , � <br />����- ��� _���-��'-� --l�L'�_ L._, �o � '� - <br />Signatwc - �— Dale <br />c; <br />