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f <br /> r <br /> . __ __ . __'-__. _ __' .-- <br /> _'_ <br /> I <br /> ELECTRICAL PERMIT APPLICA�'ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org �b _�� -/Z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �,��Z�D .r ! �� <br /> 1H��' 112 -1�. '�\ `. [ � v�•:c.�<� �n; r1 ��SZvd <br /> PROJECT ADDRESS <br /> �t1 � � ' 4�s- 33 �-�1�� <br /> �'� . � � 1c. ����c� I'13�= 1V b, Si � i F�c�c�- �t� 152c,. <br /> Owner ?Aail Address City State2p Phenc <br /> l��ar��` \c_ � ��. 1�-�°�', il? 1._ ji S.� t�_�'r,C� �.�.l� �I`/iZeFf 42i- 337-`�ll,�. <br /> Tenanl " Mailllddress City Slate/Zip Phone <br /> �l_:C: r1�Clr_ `�vpC•,� - <br /> —� Cit State2ip Phone <br /> Electrical Contractor Maii nddress Y <br /> 143^ 112 h� �st 5� Conlract P�ic ol Work <br /> State License Number <br /> h'• � c n—� - <br /> Proposed Use of Ouilding Contact Person (Plan Review) <br /> Square Foot�ge(�residential new conslruction, remodel or addition) <br /> Description of Work lo Be Done: ��' � c�� ��' h'} <br /> '. ic_l. �_„� c� ,.1��5 . i <br /> � I i <br /> � NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> E3E IN RACEWAYS MC OR AC CA[3LE . � <br /> ' Lj0 <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> � I hcref:y r.crLly thnf I Mrvc m�id nnd cru;nined fhis npphc�fion and kno�v the sarnc fo bo fruo nnd 1 O-- � C� <br /> � concr.f. All prowsions ol/mvs and o��6n;utces govemin�fhis fyp�ol roorh nill be comple(ed � I Z I � I <br /> ' �vhefhcr a�pecilicd heirin or noL Tho yran6ng o!a permd docs nof msunte tc yrvo authonty to <br /> vielete or cnnce'Ih�Innvisions o/nny olher sfafe or local law re�ul�fing conshuction or flre <br /> � pwlonnance ol consln�r.tion. 7hat I am aufhurizeJ Gy fhe mvnur ol fhis �ropert}�to pedonn Uio <br /> � �roik loi �vhich.ipplicufion is nradc and 1 roniply ivdh fl!e Slnfo Con6acfors Law 18 27 RCW and <br /> 295 200 WAC. <br /> _.�� �� Ie, -I�l — �2 <br /> S�gnelwe Dale <br />