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OB/14/?013 wco 7: 56 Pn% m002/002 <br /> � � <br /> ELECTRICAL PERMIT APPLICATION , <br /> CITY OF EVERETT PERMIT SERVICES <br /> 5200 CEDAR STREET, EVFRETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org Cj _��--�3 I <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM G 13�g`"�" <br /> ��02. 23rd P�vP, l.l �JeYeH W(k `Ig203 <br /> PROJECT ADDRESS <br /> SI.�SGYt EdYv�or�s 516z Z3Yd /}ve � �vere�', w� `���3 425- 3�t'7� �o-I'7 <br /> Owner M17ail nddress Ciry State/Zip Phone <br /> i <br /> NIA <br /> Tenanl Mail Address Ciry Stat^/Zip Phone <br /> As you w�s� ��,�u�eic Szs s sEo.c...,, s-� seo.�k�e u�fl `�g�34 <br /> Electrical CoNractor Mall Address T Ciry SlalelZip Phone <br /> ��Y�Ywq2s NM � �as <br /> Slate Liconse Number Con�ract Price of Work <br /> 'bWe��\Y�.� CrlJPVi C�Y"�i ��� <br /> Proposed Use of 8 Iding Contaci Person (Plan Review) <br /> N f A, <br /> Square Foot2ge Qf residential new consiruction,remodel or addition) <br /> oescription of work to Be oane: u RQ� �-�'(�CW� ��2nnC 1aV1 12.0 U Ol� ��SGVv�,O <br /> -Ei�r � �Jar \�a�n�5 <br /> I <br /> � <br /> (JOTE: WIRING W NON-DWELLINGS IS REC]UIREDTQ FEE [�� <br /> BE IN RACEWAYS, MC OR AC CABLE. ��� '�J <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerfily that I have read end examined this application and know�tia same to be true and �! <br /> cor�ocf. All provisions ollaws and ordinances yovemrng this type o7 viork will be completed k I >��� �J�> <br /> Iwhether specdied herein or noL Tho granfing o7 a permd does not p�esume to give authority 10 <br /> violate w cance!fho provisions ol any olher state or local law regulatrng conslruction or(he <br /> peAo�mance o!construction. That I am authori�ad by(he owner o!this properly to perlorm fhe <br /> v�o�h lor rvhich applicn6on is made and f comply wilh rhe Sfafe CoMrac(ors Law 1 R.27 RCW•r.nd <br /> 295.200 WAC. <br /> � �-cn-��. �'6,n�.11P , �I 1 N� l3 <br /> ' Signawre oate <br />