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�- - <br /> 'l <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVFRETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � f7 ��Z <br /> 425-257-8810 - FAX 425-257-8857 -www.everetlwa.org ro <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 Ph1 �I�O`-/1� <br /> I�1�'�c� 11 Z1ti ��� �� L- , l�JcR�'S� WA c18Z� `� <br /> PROJECT ADDRESS <br /> �c1:i���o-.. ., .����� 1'{�-�� i1Z���. ��� � c_ �. <br /> Jt:c t{ Wi� 9`3Zc"s HzS� 33"1-`llb <br /> Ownet fdailAdd�dss City 'Iate/Lp Phono <br /> �o.t��e\c, � !�'v. c. �-t3'� 112 1� ��t S c LVc.-e�{ M/� �`32i5 �125• 33� '`llbb <br /> Tenant Ma�l Address City Slate�Zip Phone <br /> � , ; � . �r s 5 � L✓��c wk �1 L:,S zi- 3S i -`i i�� <br /> Electrical CoNractor � Mail Address City SteteRip Phone <br /> �_.- � _ -1 -- <br /> State License Number Contracf Price of Work <br /> � .nl�Giln . ,���C <br /> h���� tic �_.��� �� l.��r C�,'-'ti"� <br /> Proposed Use of Bullding Conlact Percon 'lan Review) <br /> ' 2�C, �.r '� t <br /> Squar�Yll residenlial new conslruc�ion, rernodel or addition) <br />� hQ ` ec',d �c„� v,1 ��� 5 . . <br /> Description ol Work lo De Don¢ � �� rr ?�t�-��� � ` <br /> �� 1 c� 1� ..' �� re ,,,-,o a i <br /> I NOTE WIRING IN NON-0WELLINGS IS REQUIRED TO FE[ <br /> i <br /> 13L= IN I�AC[WAYS, MC OR nC CADLF . <br /> i <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 - <br /> i i 1 hereby co�tily fhpf 1 ho�'e ruaJ anJ erarnined this.ipphr,afion nnJ kno�v thc snmo fo be(n�e and i <br /> � conect. All provisions u//a�vs and o«linances yoverninp fhis fype ol�vork v��ll be cornpleted � Z I d- �ZI <br /> �vhc(hcr speciGed hercin ornoL 1 ho yr�•�fing o!n pennd docs nof vesume l0 9ive aulhority to <br /> i wolnfe orcancel Uie`novisiuns o/any o(hr.r sfqte orlocallaw myu��hng construcGon or fho <br /> iperlonnnnco o/cans(�uchon. Thnt 1,�m aufhonzed by fho o�vnerol(his pmperty fo perlonn fha <br /> n�ork lor tvhich npplicafion is mado nnd 1 compty wifb (he Sfnfo Confrac(ors Lmv 18.27 RCW and <br /> 296.200 I�YAC. <br /> i 1\ <br /> � C <br /> I � ' - <br /> � � �_1�1� --- <br /> � �� -- <br /> __ _-- <br /> -___- ���'�-�.-. Dala <br /> nawm <br />