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� <br />� <br />ELECTRICAL PERMIT APPLICATION <br />GITY OF �y�R�TT Pf=RMIT S�RVICES <br />3200 C[DAR STREEI, EVFRL=TT, VVA 98701 <br />425-257-8810 - FAX 425-257-885/ -��n�n�✓ everettwa org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� <br />� <br />,� � v S �L�� ��1=—��%zL�7,� ��/f� <br />I PROJECT ADDRESS � <br />„w rzo9-�oy <br />9 -�3-I 2- <br />���/1�Li1.�2C��—�_��'� n ��-�� 3 ft � 9_O <br />o i , , � ,u �. - , o�i,// �� 9��> ��-s9,. <br />C�ypn � �AailAOdress C�ty Stale'Zp Phone <br />Tenanl <br />O!/!/ f/i � / <br />[lectrical Contiactor <br />Slate Gccnse Number <br />Proposed Usc of �uddmg <br />Ida�i Adtlress <br />Llaiii�tldres5 <br />C�Iy <br />Cny <br />Slale2�p <br />SlatelT�p <br />/� 0� <br />Co ilract Pnce of Work <br />Centacl Person (Plan Review) <br />9S� � 1��_S �JJ`__.���,�ryl.�,��� <br />Sqtfare Footage Q( rc Aenlial nev+ tonsliud�on, remo I o� addtlion) <br />Phone <br />Phone <br />�l � �J <br />Description of Work to Be Done� Qitnl�� <,. __� GG �/��.��y_QX ��% � �Q— __._.. <br />�_<�pfc�c�_il�Ii--�`s _�q�����, � -- <br />l/ <br />NOTE: WIRING IN NON�DW6LLINGS IS REQUIRED TO <br />BE IN RAC[WAY'S, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />F[E <br />�Z �� <br />1 he�eby certity fhat I have : ead and examined lhis applicaGon and kno��; fhe same (o Le true and <br />conecL All provisinns o/laus and ordmances yoveming fhis type o/ work �vdl be compleled �I �O � � <br />whether speciTied heiein or noL The granl�ng ol a permd does nnf presvme lo grve aufhonty lo —�O <br />violate orcanr.el fhe provisrons o7�ny ofhersla(e orlocal laiv reyula6ng construc6on orfhe <br />perlonnance ol constn�clion. Thaf I am aulhoiized hy the o�vner o/ Ihis property �o perlorm fhe <br />r✓ork lor which applicaliun is made and I comply �mlh fhe State Confractors La�v 18, 27 RCW and <br />296 200 WAC. <br />