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� � - <br /> EL�CTRICAL PERMtT APPLICATION <br /> CITY �F EVERETT p�RMIT SERVICES <br /> 3200 CEDAR StREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www,everetriva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � 0 D 22_ 12�'"—` f���. J� EVerett, W�1 <br /> PROJECT ADDRFSS <br /> ���-��� l2gi� ,�r� .e �r a� /� g��� <br /> Q�@r Meii Address Ciry SI P�one <br /> vV <br /> Tenant Mail AOdreLs Ctry Sta <br /> �n,p Phane <br /> Pr�cis����/�����2�.s�.��,�'���.�����w�v����2 <br /> Elecincal ConUactor Moil Pdafass ciy � Tyziv pnorm <br /> preci�e ���� 5 � yoao � <br /> �tate�cense Num6er Conhact PriCe of Work <br /> U,� G�l v� � l �� 1�7� D <br /> ProposeA Use of B ild g Conta Person (Plan Review) <br /> � r' ' , <br /> Square Footage(It residentlel new construction, remodel or addition) <br /> �esaipUonofWorklaeeDone: ��� �n']p LlC� nelN l�Slde �'IfS 2�077 $'cf-�'jL <br /> ✓ — <br /> L <br /> NOTE: WIRING IN NON-DWELIINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR qC CABLE. /�O �G <br /> CITY OF EVEREiT LOCAL SALES TAX CODE IS 3106 <br /> 1 heie6Y certity thaf I have read and examined fhis applicah'on and knOw the sama fo 6e hve and <br /> torrect. All p visions o/faws and ordinences go�mmg Nis rypo oiwork wJl!be completed �' <br /> whpther specr�ied heroin ornot. The gmnGng of a perm7t does notpresume to givo authority to � � �,��� <br /> violetp or cancel�he provisions of any o�her state or locel law rogula6ng consnucG'on or the � )�� <br /> peRormance ol c+�n�tiuchon. 7hat l am authonutd Dy fhe owner ol this pioperly to eAam!he <br /> work(or whrch applicatlon IS made and 1 campiy wrth the Sfate Contra�ors Law fH 27 RCW and <br /> 296.20D WAC. <br /> � �� �plzo � 3 <br /> i9nalure pate <br />