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lk��31i7.0!3/ifl�' 04��'.5 PP,i FP] Seattle F.-'.}: fio. ��252°p9�,OC f'.Ofjf/00': <br />� � <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERE7T PERMIT SERVIC�S <br />3200 CEDAR STREET, EV[RETT, WA 98201 ��� O� � I�3 <br />425-257-8E310 - FN( 425-257-8857 — wvfv�.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 nM TO n PM a`ab -� <br />�l�C M F .�1e.rQ t�ee,. Wo..,, <br />''ROJECT ADDR[55 --`T <br />1��v�.r�Cia. �C rG1�ce.-i� -1Boo E.�vse�-etnwQ..., �e�.ref-a� �..�A 9�n3 <br />O�r+ne tda�l AOtlreso �� Gily r Slele/Zip Phone <br />7enant <br />��a��� naaross <br />Gty <br />Slole2ip Phone <br />� �/� yY.S- -L`] O' <br />F•�ce, �t ri7�� �lLv� �1t. �(�� �Z �o�Z �l+C�� v..rl gg�� g6(� <br />Electncal ConVaCtor lda�i adaress City Siate2ip Pncne <br />� ��E_�1'kOZ1Yn�- <br />Slalo License I�ufllbCf <br />C,��.t�m �-c_`,ol- C.4� 1 o�\c¢.s�.; p <br />Proposed Use of Bwldmg <br />�Sct� s ,Sh• <br />Square Foolago Qf rasidential nc conslNCtion, rBntotlC�� or adtliuon) <br />� � O� ' o0 <br />Contratl Pnce O( Wotk <br />�11Q.� �4r� <br />COnIaCt P9rSon (Plan Revicw) <br />DescnpLon ot Work to Ba Dnne� � ny� ��\}g.,�.�j r'��ar� T Z. � <br />NOfE WIRING IN NON-DW[LLINGS IS R[QUIRED TO <br />�E IN Rl10EWAYS, MC OR AC CABLE. <br />CITY OF EV[R[7T LOCAL SALES TAX CODE IS J106 <br />IOoro�y corfdy thut I hovc reatl and oxaminod this spplicsfion and know No sam� tc Oo tn,o and <br />cormet Al/ provis�ons o! l�ws ond arCfnonces govanung7his typo of work wlil Ge cornpletod <br />whe�hei spocibod hcrc�n a�not. The gr�nhng o/ a pormrt does ootp ,resumo fo pivo authonty to <br />vro�are or cancel the provisions ol sny omer st�te or locai law rec�ulat�ng consrrucaon or the <br />pBAomtance o� r.onsrrudton 7hat I am auUronze0 by tlie mvner of (his roperly 7o perlomi the <br />wo�k lor �vhlch appliCafion is mada and 1 comply wiU� fhe StBfe Confiac i5 Law 1 F3.27 RCW and <br />296200 WAG � . , . <br />/// 3 <br />F[E <br />�2 � <br />�(���-(g.3 <br />