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--- • - -------l-------- i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT F�ERMiT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WN 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> � �p S -I 3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � ��a- -�Y <br /> 1 t �1 i 5 � ; �ve-�" l�.�� � _ <br /> PROJECT ADDRESS <br /> f�l�`'�ov� ('�v,'�� I1�( IS ��`IJev' HPkc. �Or. ��c�t� !n-i9 4ls=2/� '/_, � <br /> Owner Mad Atldresc City 51ale/Z�p Phonc <br /> Tenan� 1.7a�lAddress Cny Slate/Lp Pnone <br /> �/z5 ZFg <br /> us�ti� ,F/rc fr,'c:, 290 5� /Gs' h fr S�—t30 {Gre // ��f 9�'�/� ss <br /> � <br /> [lectrical Conlractor l�lanAddress Cnv State2ip Phone ' <br /> Se(?� '�l.o'd 07 3 Zoo `., <br /> State Licen;e Nurnbcr Conlracl Price of Work <br /> Pr��Usc of Buildmg Conlact Person (Plan Revicw) <br /> Square foolage(If resldeN�al new conshuction, remodei or adddion) <br /> Description of Work to 6e Done. �ji(,-,.y_�iJC Yl G v�c� _��,p���M�;�,� <br /> �_` <br /> NOIE WIRING IN NON-DWELLINGS IS REQUIRED i0 I FEE „y1 <br /> BE IN RACEW�YS, MC OR AC C�DLE . �7�/ <br /> 5� <br /> CITY OF EVERETT LOCAL SALES TAX COD[ IS 7705 - ---- --- ------- -- - -- <br /> I hP�eby r,crLly Ihat 1 hnve rend 2nd exnmmud Ilus .app6r,alion and knnw Ihc s,�rnc fo br In�c und (� �`� �� _ ��� <br /> r,o,m-.' All provis�ons ol laws and ordm�u�ces�ovr.mmg Ihis typc af work wi0 hc cnmplcicA [_ 7 <br /> v�h��fherspemliod heran or nof. Ihe gnnOnry ol a pennr!does not/uesume fo yive uufhnnty lo <br /> wolafe ur cancr.l fhe prov�sions ol any o(he�sfofe orfocal!aw mgu a6ng constn�clion or fhe <br /> per/ormance o/%ons(n�cfion. Tha(I am aulhonred by!!ie owner ollhis uopnrty lo pe�fornr!he <br /> work/or whir,h app6c��bon is madr. and 1 cornply wAh fhu Slulr, f.onhnr./o��L.+�v 1 E 27 RCW and <br /> 296 20 WAC <br /> ��� — -- �1,��Z0 / �� I <br /> s�ynzyric — oa�c � <br />