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EL�CTR��AL PERMIT e4PP�ICATION <br /> CITY OF EVERETT PERMIT SERViCES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-II857 —www.everettwa.org � _�(�—/Z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM (��j�7--�6� <br /> J �`� �� {I� ��� � �� VPII vL/ � 1 /�� ' <br /> PROJECT ADDRESS <br /> ��.� b � �,« �. • ,�.t����� �i1 �e-l�,� � ��tl- �A <br /> Owner � Mail hddres �Sj�-t-. , / '(-'��� City State!Zip ��Z� Phone <br /> �µlx I <br /> � rl SP,-, `-fZS-25 I -1`(�E: <br /> Tenant Mail Address City StalelZip Phone <br /> 5 z\ � � �;\^\�`,n�, �e ,� \�� �C11�V�� �� � ��� � 5a r�tS- <br /> Elect�ical Conlractor �.- Mai�Ad ress City StaterZip Phone <br /> Siafe License Number Contract Price of Work <br /> �7{1 �L�� ��G 1tit-�/ <br /> Proposed Use of Bwlding Conlact Person (Plan Review) <br /> 1 <br /> � 3 `l 5 5 , <br /> Square Foolage Q(residen�ial new constructio , 'em el or addilion) <br /> Descripiion of Work lo Be Done; ��'eU./ n �,e� L �0 �e �v�oJa� ��/ <br /> � n� �1�]�.(IC Gl� 1'la / <br /> i <br /> I -- — <br /> I� NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> I BE IN RACEWAYS, MC OR AC CABLE. -7� � <br /> c <br /> CITY OP EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ce�ti�y thaf I have read and examined this ap�licafion and kno�v the same to be tnie and ,-- r <br /> conecL All provrsions ollaws and o�dinances govemmg this type o(wodc will be completed � 120� —�`Q� <br /> � �vhefherspeci(ied herein ornoL The granting of a pennrt does not �resumr, to give aafhonty to • <br /> violate or cancel the provisions of any other stafe orlocal law regulafing construchon or the <br /> perlomiance o(cons(nictrun. That 1 am aufhoiized by the owner of this properiy to perfomi the <br /> n�oric for�vliich applicatio�i is made and 1 compl}�with the State Contracfors Law 1827 RCW and <br /> 296200 WAC. <br /> �� <br /> lil�1�-�v ���i.�'" � � l0 � � <br /> Signalure � Dat <br /> I <br /> - ---------------- ------ _.._ <br /> ---__. .__—�— -- ----- ., <br />