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0 0 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 2 5 ( Jo/�dcz„, / / <br /> PROJECT ADDRESS <br /> ,4 44/A.-7 n 1.--c _.(2e.c. e,,,, 4,u,. �-,+ .3-1,Q r <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> OS 07-- .•(,.c:_74..„,..._' ,z.,-„- ZIX:s-{ t--cA•e-• 4-/,-4- 9 Zi...,j <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> I9501-?.4 * ec- ,2_,2_ (? 2- ` GC.' <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> //i(& <br /> Square Footage (If residential new construction, remodel or addition) <br /> Description of Work to Be Done: 7` C1�( - isCS, tc-t p;Ny,i,,1. - v-ic:D 5 ' J2 l-)cv 11/4-- <br /> NOTE: <br /> 1/4--NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE . <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and examined this application and know the same to be true and C! - DS,_ Cc--(C Si <br /> correct. All provisions of laws and ordinances governing this type of work will be completed � <br /> whether specified herein or not. The granting of a permit does notresume to give authority to <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of thisproperty to perform the <br /> work for which application is made and I comply with the State Contractrs Law 18.27 RCW and <br /> 296.200 WAC. <br /> - _ _- y, _ _,`,:,__- <br /> Signature Date <br />