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0ooziooz <br /> O1/IB/=013 FRI 15: 31 FAx -- ----- <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, GVERETT, WA 98201 <br /> 4�5-257-88�0 - kAX n25-257-8857 —v�nvw•everettwa.org I , I,g _ �3 <br /> APPLICATIONS ARE ACCEPTE� FROM 6 AM TO 4 PM C � .3d� _�OL <br /> 3�1 � � �h D �e �1 ve <br /> PROJECTADDRESS <br /> o�.dU,,� U�ZS Zi �' <br /> ��s�� '� � i ���or?� fi Ye ���r ��-�- �Jfl�l`�2�3 2e��� <br /> � Ownet M11a�i Address �'�1' <br /> State2ip Pnono <br /> \� i ! . _ __ _\�- - ___.. _. . . _-_ __ '__. _ .. <br /> _.-___..__._—_.._. _.__ . <br /> _ . __ ... . . . .. _. <br /> .. . � - � - - -- �- - S�atelZiv �°�2 <br /> Te ant � M1failAddress Cny <br /> 1�S YO � v� S-r� 2� J <br /> -��c�� � g25 s�3-ac�- � S�a.-M�te l,J��►� (3�1 2Sz� <br /> EIBC�fiC�l COOlf3GtOf MOiI PAdress Clty � <br /> State2ip Pho e <br /> f� S�OU.�f� q25�f'�l 2-100 <br /> State Liconse Number Cyqr��Pn1'ce o Work <br /> �-7 / � SMGcS�G� <br /> 1�Q S\ (�a'�i GL\ -��2L��.1 C«� 2�7i n -7`�i3 �SZ I <br /> Pr�posed Use of Building Contact Person (Plan Rmview) <br /> Square Footage(i(residenlial new consVuction,remodol or addition) <br /> Descnption ol Work to�e Done: <br /> N� t,J 2U Dv� �w Gt`2u-i-i-1-�0 I�.P���"�un'1 <br /> � ��R v� ��V��(,�. Gl 2 c�1.1.��' -ro C{.1�2 1�G��t G{.(.-�.l2� <br /> ' 120� I��- C-1�u,l�� -�x-t-.�✓1S1�S' � �� 6�-C� 'S �- Z 1 ��is <br /> PIOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO I 1[E <br /> BL IN RACEWAYS, MC OR AC CA6LE. I �� � � <br /> I CITY OF EVERETT LOCAL SALES TNC COOE IS J105 ` <br /> 1 hereby certily tl�at!have rcad antl examinod fhis ap�licafia�and know the samo to be hve and <br /> cwiect All pruvis�ons ollaws and ordinancas govomui]this lype o!work will be compfeted �I �n I � I � � <br /> r.hethe�speci6ed herem or noL Thc gianfing of a pennd does not pmsume to give aufhority fo V l <br /> �vola(e or cancel the prorisions o(any ofher sfate orlor.al la�v regulafing cunstrucfion er fbe <br /> peAermance o�constr . Thaf 1 nnt authorized by fhe awnero�this proPetly to periornt fhe <br /> work!or vihich appli ation i mado and I comply�vith the Stata Conhactors Law 1817 RC W and <br /> 2g AC. <br /> , � ` I � ) � � _ <br /> Signa re U t <br /> --- �2 <br />