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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 /> -, a b I U RC'j ate- ke--. <br /> PROJECT ADDRESS <br /> Z0.5c0\ 4.-- &-W CL3 ? <br /> . <br /> Owner Mail Address City State/Zip Phone <br /> SPsre\k <br /> Tenant Mail Address City State/Zip Phone <br /> q AS— <br /> F4cs *uTcx -+ - VNCJ \D-LS P\ q`451-NE htsi-co e st AIto-2o <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 1 e cD 0.1-_3 L <br /> State License Number Contract Price of Work <br /> ProposedP"e-g%4, -( <br /> ttUse of Building Contact Person (Plan Review) <br /> Square`Footage(Yresidential new construction, remodel or addition) <br /> Description of Work to Be Done: �; t e".. v'b ` r c- T'`' in(Lv0 Ut' <br /> MO t) f ©4- k-4- k--\-- S k�, S S w y S' / 0\S Pies4De <br /> U /� 5 <br /> ��- h` ti ft,e,‘„, s w la / p v v-P)vv\ l� , <br /> NOTE: WRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. 75 <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 <br /> correct. All provisions of laws and ordinances governing this type of work will be completed ei301 <br /> �� <br /> whether specified herein or not. The granting of a permit does not resume 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 1 am authorized by the owner of thisroperty to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> illk \A„...S.A.7.____\_, <br /> Signature at <br />