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� � <br /> ELECTRICAL PERMIT APPLICAZIOIV <br /> ' CITY �F FVERETT PERMIT SERVICES <br /> 3200 CE�AR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-�wnv.everetiwa.org /� ` a� _�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �.'1'�/p . / (�y <br /> l v t��7 C.�-�S'qC�c-e� t,.,�.� <br /> PROJECT ADDRESS <br /> So� P�:Nfe <br /> p�z�. �cc yw �� �,�, sw.Z�i 2�I�c �9�r�,�c 4i� `�t ���1�7 <br /> Jwne� Mail Address <br /> City State/Zip Phone <br /> �-Il � bu7 Ev� Sce-� •.� E�zSc�-� l.� (� �' �26� <br /> Tenant MailAddress City State/Zip Phone <br /> � 36�.�2Y-t3� <br /> �-�s-S��q� � t�,us�. 26� �� �� �,�-�-�, �;rU��,, � qsz�3 <br /> � State/Zi Phone <br /> EleclricalContractor MailAddress City P <br /> ���m <br /> �e.�.e.�sC�'f 2c� � <br /> State License Num6er Contract Price of Work <br /> r �Q�ll ���,�� <br /> �o"1�eH�'c•�c� 51'ure <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residenlial new construction, remodel or addition) <br /> Description of Work to Be Done: <br /> �ks��t 3 �� s`���^S — <br /> ���j'Ica� � lMo ti.i w��e.•n_ I Sic{� le� �e��4C-e �tsi�c tt� Il�tov�wa.�,� 5�911 <br /> d <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 8E W RACEWAYS, MC OR AC CABLE. <br /> CITY UF EVERETI'LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi�y fhaf/have read and ezamined this applicalion and know fha same to be true and C i -Z v_ ' �f ' <br /> correcL All prowsions o/laws and ordinances govemmg fhis lype olwork�vill be completed � 7 <br /> whether speci(ed herein or not The granfing o/a permd does not p�esume fo give authonty to <br /> violale or cancel fhe provisions ol any other state or local law regulafin9 construcfion or fhe <br /> IpeAomanre ol constcichon. Thaf I am aidhorized by the mvner oI fhis property fo pedorm fhe <br /> work(or which applicafion is made and I comply wifh fhe Stafe Confractors Law 78.27 RCW and <br /> I2�6.20C WAC. <br /> u�-�-1, '�' ( c`�- 2 �(`c� - � <br /> Signature Dale <br /> � � <br />