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__...__-- -_-__-- i, <br /> ELECTF�IGAL PERMIT APPLICATION j <br /> CITY OF EVERETT PERMIT SERVICES <br /> I 3200 CEDAR STREET, EVER[TT, WA 98201 � �I ` /� <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.ory /1 '��g��7 <br /> \J <br /> i APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I <br /> li <br /> ', �(� Z�G i(rrV��'1 1�'� IN I <br /> I PROJECT ADDRESS <br /> ii I <br /> I Cul�v ��u�e �1�p2Cn !lot{� I�r �Iv ��12.�� \�1 A °I�Zo�-I '�� <br /> Mail Address Cit, SiatelZip Phone I <br /> Owner I <br /> I <br /> I Tenanl Maii Address C�ty StatelZip <br /> Phone �� <br /> I�S `ICIn bU �SN c�ct��c gzs S 5���-�� �-� S��t��� W� `���3�1 <br /> ' I.taii Address Cily SlatelZip Phor� <br /> � Electrical Contractur � <br /> Ij �S`Iouy�U�2s Nr� ��}13 �Z '� <br /> '� St�te License Number Contract Price of Work � <br /> `GJ 1'� CCIf hi�� 2,Cf�a��.�_ I <br /> �� Proposed Use of Building Cantact Person (� an Review) Z�Z�j i <br /> I I <br /> � Square Foolagc Qf residential new conslruction, remodel or addition) <br /> �� Descriplion o(Work to Be Gone: I2� V OLT I `S UV�� � ���'�'��� �7`�"��1 f�11� "�� <br /> ! _ �, ce �\�nU fc�n -F�,r a. re5;��e��-��\ home <br /> NOTE: INIRING IN NOf'-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. `� /� C� ` % <br /> l, l, <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � I hereby r,crtil�Ih?(1 hr�rc�ead and exarnined(his apl?lication anil kno�,v fhe s�me to be true and � <br /> � co��ect. All provis�ons o/Inws and ordinances gavernmg flus type o1 work will Ue completed � <br /> '� �vlienc�r speci(icd herem or�wL Thc yranfiny ola pernnt does not p!esume!o give authority to � I �7 C) , � CIC�j� I <br /> '� violdle or cancel the provisions o!any other state or local law regula6ng conslruchon or the � / I <br /> perforniance oI consVucfron. Thaf I arn authorized by the ovmer o/(his property fo perform the <br /> � wnik Ior�vhich applicalion � nadr. and 1 comply wifh the Stafe Contractors Law 78.27 RCW and I <br /> 29G.200 WAC. � <br /> � <br /> SiynaWre Date <br />