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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE: , EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857--www.everettwa.org ��a j—/Z <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM (y /ZO �.-/I I <br />��,��f� % �2 % i`d <br />PROJECT ADDRESS <br />�,n ' i '% SE� C!<Glt�t; A=��- y%lofl��.lSa-o69P <br />,11i/!G" 1 %AA�I'4�e.� D%� i �i� 7� _ <br />Owner Mail AtlCiess City StalelLp Phone <br />5 n,,.t as R 6�-J e _ <br />Tenant Mail Atldress ���Y <br />r <br />v�� k�CCf/t�c�... .s�. <br />;'E9�. �3�'f� i-L <br />Electrical Coniractor MBiI AddfP,55 City <br />`j N 1 ECc i-uE,r65 <br />Sta!e License Number <br />/ <br />C7Rs S'IAti.✓��rr.i, ��Q.. <br />Proposed Use ol Bwlding <br />Square Foolaye pl residenhal new construdion, remodel or ad0ihon) <br />Description of Work to Be Done ��c -�-- <br />`q �C/ s ��..✓o ��,'2 �: /� �L� KC(� 4 . _ <br />NC)TE WIRING IN NON-DWELLINGS IS REOUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />State�Zip Phone <br />K .7�� u.�� qs�ds ;��� -rr���s <br />State/Lp Phone <br />� � <br />ooc <br />Conlracl Pnce o Work <br />� Rcc �AF#� l�c •i1a -zP�e 1 <br />Gontact Person (Plan Review) <br />�lw� 'OK <br />1 horr.by certily thaf 1 have �ead end exanvned Ihis apphcaGon end Anow fhe sama to be frue end <br />conecl All prov.^ons allaws anAordrnnnces govermng fhis type o! worh wdl be complefeA <br />wbefhe� specd�ed h�rem or nol 7he gran6ng ol a permR does nof resume to give outhonty fo <br />�iolate or cancel fhe provisions ol any ofher sfafn or local law reguP(mg conshuchon or fbe <br />;�eAormarrce ol construchon Thaf 1 am airtbnnzed by Ihe owner ol this rop�. �ty fo peAomi the <br />r�o�k lor which epplicahon is made and I comply with fhe State ContracPrs Le�.v 78 27 RCW and <br />: 96 200 V�'AC. <br />r � ' i <br />� �� <br />FEE <br />�13�U�' ill <br />