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�LECTRICe4L PERMfT l�PPLIGATION <br />CITY QF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS RRE ACCEPTED FROM 8 AM TO 4 PM <br />� , - r, <' � ( <br />, ', <br />�j�.1/�f (�t` �)r i_,'��"�` <br />PROJECTADDRES/S � <br />1 :�(����-�,� l�r iSf"l<«i <br />�D+�� C;�< 1��,�,,; UI � r ��ri�c;�;'; <br />Ovdnef Mail Address <br />Mail Address <br />Cont�aclo� Mail Address <br />� G1 <br />Slat License Number <br />E��� ^ 1 �'ii �� <' l <br />PropasedUse of Buildiny <br />�7 f � i(j ..1� <br />Square Foolag�(If residential new cons(ruction, remodel or addition) <br />�1 -� i n <br />De=cription of Work to Be Done: �t' �( �.�i i��� i��; (".� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CAGLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />City <br />StatelLip <br />State/Zip <br />Slale/Zip <br />Phone <br />Phone <br />rnone <br />�, ,,°�l�r* m�m S� ;n�(i�'� <br />Conlracl Pri e of Work <br />� � h r/'�',e', � <br />Contact Person (Plan Review) <br />, � -� <br />� � , ,, <br />�L�/ j �i <br />,:l, <br />FEE <br />'��- 00 <br />ll' <br />1 heieby ceifify thaf I have read and examined this application and Irno�v Ihe same fo Ge �rue and � ` / <br />�orrer.L All provisrnns of /aws and ordinances yovemmg th�s type of �vork �:�ill be completed J� I� —Ol_�� <br />r;hclher specfied herein ornot. The granting of a pennd docs notp resinne to give aufhorty to <br />rblate or cancel the prov�sions of any ofherstate allocallmv regula(ing cons(ruclmn orthe <br />p��rformance o(constiuchon. That I am aufhorized by the o�c�nero/thisp roperfy ro pedorm (he <br />�;o�k (or �ahich applicafion ia made and I comply �vith the State Contractors Laiv 18.27 RCN1 and <br />276.200 INAC. <br />�, . <br />�i <br />_-_ ' `- <br />- Biqn�fure <br />