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��-� <br /> , ''� <br /> - - ---� ; ';,� <br /> ELECTRICAL PERMIT ApPLICATION � �"�" <br /> .�:�; <br /> j� <br /> CITY OF EVERETT PERMIT SERVICES ',-�'� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 (Q �a 3- /Z I °' <br /> 425-257-8810 - FAX425-257-8857 -www.everettwa.org C/�0-�5� � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> =i�av <br /> �x� ���;� <br /> /�,a L, .�//�; � .�/aio -��� <br /> PROJECT ADDRESS <br /> 1 vg2s __ /5�� �{/�'� ,L"c��X�r� l��?o/ <br /> Owner PdailFddr=ss City State/Zip Phone <br /> �G,�`2J � �vl� ��r Slale/Z� Phone <br /> Tenan� Mail Address City P <br /> FL,7�� �%� �� f���i/2��.. ��j . ��X ��2�� �it�r�c• ,, (�-�'r <br /> 1�1ai1 Address City State Phone <br /> Electrical Coniractor �/� 1 - ���� '(o�Sv <br /> ,�,�tI,C- � /.3.� �l _ ��/ G `1° <br /> State License Number / Conl act Price of VVork I <br /> � o7..7CiZ� SL� { � <br /> /Q,L..S��/-Lr/1�{-ti l �X�S i �V Ci Contact Person (Plan Review) <br /> Proposed Use of Building <br /> �o( �Q �� �f <br /> Square Footage (If residential new conslruction, remodel or addition) <br /> Descripfion of V4ork l0 6e Done: (t�fC�UG � •'`/.�d/n rf' � ��V � � x����P 5 �(�«/�'N <br /> i / — /� i r <br /> �i N•c�s nD �nx��, .t�� w /C[Z��SFn ��� f iK�'tc�i s i � <br /> � `' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RAC[WAYS, MC OR AC CABLE . <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i I hereby certily tlr?t I liave read and examined ihis ap��lication and kno�v(he same to be t�ue and � ��,�G— �S� <br /> currecL All prowsions cf laws and ordinances,roveming fhis type of�aark will be completed <br /> whetherspeci6ed herein ornof. The granting of a permit does notp resume to grve aulhonty to <br /> violale orcancel the p�ovisions of any ofhersfate orlocallaw regula6ng construchon or the <br /> pe�/ormance of construction. That 1 am a�dhonzed Uy the o�•�nerd this property lo pe�fonn fhe <br /> work(or which applicafion is made and 1 comply i^ntii the State Contraclors Law 18.27 RCIN and I <br /> 296.200 WAC. <br /> (� ���uL�e�(i� i�+� /D -//- / Ii <br /> SignaWre Date � <br /> � <br /> :s� 4�`�.z��e�'' �. <br /> �.. <br /> � ' . . . p" . . .. , � n � — ` �. .- _ ... ' <br />