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_ --� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ���a �— /Z_ <br /> 425-257-8810 - FAX425-257-885:'—www.everettwa.org �� <br /> L/ zOs—I l n <br /> APPLICATIONS ARE ACCI_PTED FROM 8 AM TO 4 PM <br /> �� ��� j I f�� .�i/� S G� �1 b��c�'�� <br /> PROJECT AD�RESS <br /> S,f��IG�• , G(�GiCf� ll�fSl/ <br /> OWner MailAddress Cdy State/Zip Phone <br /> � <br /> � <br /> a1�s��= h„�.�/ ��,-t h,� «•� <br /> Tenanl Mail Addres� City Sta�e/Zip Phone <br /> I(/ /�4<t�'S if�E/G� a a� � .S 1�03 S<���ii �dC r`U� �f� r� '.�SN !��vI <br /> Electric2 �ont�actor MailAddress City State/Zip y�s 3� Ph�e�� <br /> �'c � <br /> -..Q <br /> ,� I �/ir-,i Y%`/C 5� 3c�;D _ <br /> State License Number Conlracl Price ot Work <br /> � l P_� I l.t 1�1 I CS'�� \� .S..N-,�t�rs' <br /> �� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Square Footage(If residenlial new construclion, remodel or addition) <br /> Description of Work lo Be Done: Tr��� +/j i��`xLOvSf�FT <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> I� BE IN RACEWAYS, MC OR AC CABLE. ����� <br /> ? � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerii(y fhat 1 have read and examined fhis application and knov✓fhe sarne to 6e tn�e and -� �' <br />� correct. Al/provisions of laws and ordinances govemmg lhis type o(�vork will be complefed � � GQ� ` � � <br /> I vdhelher speafied herein or not. The granting of a pemut does not presume to givz aufhonty fo <br /> violafe orcancel the previsions of nny ofherslate orlocal law regulating conshuchon or the <br /> , perlomrance o(constn�chon. That 1 am aidhonzed by the o�a�nero(this�roperty fo peAorm the <br /> �r✓odc(or which applicalion is made and 1 compty with the Sta(e Contrac ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �-� ��,� , <br /> � �. � , �..1� �-Z3—iz <br /> Signature Date <br />