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i <br /> ELECTRICp►L PERMIT APP�ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET�, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org � -�3-��- �z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM G� ����� <br /> �?�� Cu -�- S I I V� lai�e. <br /> �1�� I �k= ���, ����.�;v�v,��-�w►�� 2 2v� <br /> PROJECT ADDRE33 <br /> Sr,��xwc�lrv..��ur�.h�)�1� I`}�1�i �-�lc�:l��a��t1_ Cu�k�,2�� 11Jr�lnu�1 ,v � c�a�=,�{� <br /> Owner r Mal�qadress Clry Stato2lp Phone <br /> � � <br /> � (�k.�..�o.�y — A�-C V+.— c ��'. ��1lR <br /> Tenanl �—Mal1 AUtlres> City Stele/Zip � Phone <br /> 2(.t��1k7.2' (.P"i`�t`7 <br /> �11a1�'.L�lc�, v���� 1�-�I '� k���k� CN�e�S�ua'� >�,�r��. .w�A ll`�I��l 1(�J:U <br /> Eiedncal Contractor Mall Add�eeo cuy Siaie2iu Phono <br /> � <<.: � � ��.r��) . <br /> �--���--n � , 2-� � �� _ <br /> Stele i.icense Number onlratt Frite o(Work <br /> ��,Y�VIU.�I.��� , <br /> Proposed Use o!Building Contact Person (Plan Review) <br /> `�U�c � �u� ��.����� x 22.a <br /> Square Footege U(residential new cvnsiruclion, remodal or addition) <br /> Oescription of Wurk to Be Done: �� �,��� � �� vv �r'� '�"' �lAb13Ea-- <br /> ��,�, ���,�w�- G�AV�r.�.R- __ <br /> ' NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> I BE IN RACEWAYS, MC OR AC CABLE. <br /> ICITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> � <br /> i horoby cortify thaf I have road and ozaminod this 2pplicalion and know(he seme to be fn�e and t!i��— ��� <br /> comocL All piovisions o/�aws anU ordinarlces yovendng Ihis type ol work will be complefed V <br /> whefher spnci/ied herein or not. 7he grsnfing of s pemut doos nof resumo lo givo authoiiry fo <br /> vinfate or cancel the provisions of sny ofhar stato orlocal law�oguPao�,9 eonstnreuon or rne <br /> pedonnancc of construction. Tbsf I am aufhorizod Uy fhp owner ot fhis pioperiy to perlorm Ihe <br /> �vori�tor which appiicafion is mode and I compty w;(li fha Sfu(a Cunlraclors Law 18.27 RCW and <br /> 256.200 WAC. <br /> �1�Q�� � " ?",O 11_ <br /> gnature oa <br /> id bld£S�£0 2If�Z 0� 'he�J 066b-8Z9-90Z: 'ON XHd AlI21f1�3S NHIQ21Nf1�: WOb� <br />