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i--- --- ---- --- <br /> ELECTR;ICA �L PERMIT APPLICATION <br /> C17Y Of= EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 58201 (�_�3-!3 <br /> 425-257-8810 - FAX425-257-8857 —www.everettwa.org �1306-07(� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> II <br /> ; �:;z, I <br /> /�>3i 7`��' /ii�.. S�� �'�✓'�"; l��-, i���� <br /> PROJECT ADDRESS �<�!r'� <br /> �� ��� � � (�/ i�/ � n� Y� � <br /> %��!'��.�1•f'/�iri /��7�� i�'' /��'� L�/ ����!✓e'j1= (✓�,r.�l/0 �<��7r' 1�pyr <br /> Owne� ' �dail Address City Sta;elZip Phone <br /> Tenant Mail Address City StatelZip Phone <br /> ,f' i > _ <br /> � y <br /> � ,.�j - n a-7 <br /> Z%fi7'i�+ �f'i� > �/l��fJUQ�vf��•% ltt��1��L' I ��.�G7 GID'�/���(/��L/r`1� 1���+ IlN%Z ��'z-i-r) 'lY/r <br /> � State2i Phone <br /> Elecirical Contraclor Mail Address � Ciry P <br /> � �r�s��Jz. <br /> �1�.�,,, �9f�J/k� <br /> Stale License Number Contracl Price of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> � <br /> � <br /> Square Footage(If residential new construction, reinodel or addilion) <br /> Description of Wurk lo Be Done: / �•'%�i'� �" �(�'�'���''��� ����� <br /> i <br /> -�. <br /> � <br /> � <br /> ��OTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> i BE IN RACEWAYS, MC OR AC CABLE. �-- (,C' <br /> I`� <br /> I � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I I hereby ceRily that I have read and examined this application and kno�v fhe sanm to be Gue and <br /> correct All provisions o(laws and o�dinances govemmg fhis type of n�odc r:ill�cornpleted � I � ` / , <br /> whefherspecdied herein ornoL Tiie�ranting o/a pennrt does not nesinne to ive aidhont to L � — C��k <br /> violafe or cance/fhe p�ovisions ef any other state or local law regul�tiny consWcfion or the <br /> pe�formance o(constn�ction. That I am authonzed by(he o�vnero(tlusp�operty(o perform the <br />` . � �vork lor�vhich applica(ion is made and I compty r�irh the Siate Contracfors Law 1827 RCW and <br /> I 296.200 WAC. <br /> � <br /> ��`----- � ��;'•�,i <br /> I Signature Date <br /> i <br /> ' --- -� --- - - - �---- -�--- — � -- — I <br />