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� � <br /> . --- — — — � <br /> ELECTRICAL PERMIT APPLICATION I <br /> CITY OF EV�R�TT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —wvrn�.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> l 7 OZ 44 e w � �4-F l�Ut �IEYt�-F- CcJ/� �ZL>� <br /> , <br /> PROJECT ADDRESS <br /> U_��al K <br /> O�vner �dail Address C�ty StaterZ�p Pnane 1 <br /> � <br /> I <br /> Tenant M19allAddress C�ty StatclZip Phone � <br /> 5�1�TAc c/Ec� �c �vS6 Sz2a�'ti`sf Kc�-}f- �tiA 9g6.32 I <br /> EleclriealContractor fda�lAtltlress C�ty State2io P�one <br /> S �� 1 /�C �l C�7� 'RW ��� <br /> Slate License Num6er Conlract Price of Work <br /> � Proposed Use o(�udding Conlacl Person (Plan Review) <br /> 1 <br /> Square Pootage(If residential nevi construclion, remodel or addilion) <br /> i <br /> Descnptianol�":ork1o8e0one�. QI �C�1^�N�CT L�.C+�+ v QE CO�ili1JE�"� _ <br /> NOTE WIRING IN NON-DWELLINGS IS R[4UIRED TO FEE <br /> DE IN RACEWAYS, MC OR AC CADLE. �� S� <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 — <br /> I hereby certily fhat I have read and eramined this applica(ia�and kno�v fhe sarr�e fo Ge frue and �j <br /> correcL All provlsions o//ar�s and ordinances govemmg fhis type ol�•�ork viil!be completed C � Z� p � o/� <br /> �vhether specified hcrein ornoL The granling o(a peimd does nal presume lo give aufhonty fo l� �r <br /> violate or cancel Ihe provisions oI any other state orlocal la�v re9ulating construcfion or Ihe <br /> per/onnance ol cons(ruction. That f am autlionzed by(he oc.-nero!lhisp roperty fo peAorm fhe <br /> work Ior which applicafion is made and I comply�ai(h Ihe Sfafe Conlrac(ors Law 1 B1i ftCW and <br /> 296200 AC. <br /> g - /y - z��Z <br /> �5,9�� ,� Date <br />