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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 /> f(k <br /> \-- t-‘ ecc-kC v GLLL(( AV <br /> PROJECT ADDRESS <br /> , <br /> , G'\ Vk A‘24‘ 6 GANtAcwi pl.- t-i ebuura_t_tiLAve <br /> Owner Mail Address Stat ip Phone <br /> EvC at ft \,vh 8-9.6 i <br /> Tenant Mail Address City State/Zip Pho <br /> (bd.43n) <br /> SAC'tK'(- '31z3- IJE 'At If9c VoivAtimAgic_ (ot) c ioL .01.7712- <br /> ' Electrical Contractor Mail Address City State/Trp Phone <br /> &)4:4;-ct•-•.* a14° 0 i° Ir."— <br /> State License Number Contract Price-- of Work <br /> ,Contract <br /> Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction,remodel or addition) <br /> Description of Work to Be Done: <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS,MC OR AC CABLE. e, ® a�, <br /> 0 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I herebycertify that!have read and examined this application and know the same to be true and � /��� <br /> correct. All provisions of laws and ordinances governing this type of work will be completed J ' GI� V <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 t <br /> performance of construction. That I am authorized by the owner of thisroperty to perform the <br /> work for which application is made and!comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � <br /> � - i' IcSlis <br /> Signature ��~ Date <br />