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��', I�•n a{ yc3Z. f�I�Y �l i��- <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, N1A 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />_.�r� 5 0 /�1 D <br />PROJECT ADDRESS <br />n <br />l"enant <br />r f <br />� V � <br />� ad���,� <br />� �v�o /�tvvf <br />Mail Address <br />1�0 � 5 cC.V�2v �,� � / '�n� <br />E�ectrical Conlrac or Mail Address <br />��� I�-� c.i�� �'/ �-- �T�F <br />Slale License u ber <br />Proposed Use of Building <br />City <br />✓� <br />aty <br />�! <br />State/Zip <br />�Vev��11- 'vtl /} <br />Slate/Zip <br />LV ��M� W �'�� <br />StatelZip <br />c_� � <br />��� <br />Conirect Price of Work <br />Phone <br />�(T / <br />Phone <br />7�p �� � <br />Phone <br />Contact Person (Plan Review) <br />i <br />Square Footage Qf residential new conslruclion, remodel or addition) <br />Description of Work to Be Done: L E D `<��t � %/i/ �«l� ctt �-°d (ei� I�� c I�' <br />�' � <br />� �,��� �lo ��-�� <br />i <br />� <br />' NOTE: WIRING IN NON-DWELL:'JGS IS REQUIRED TO FEE li <br />! BE IN RACEWAYS, MC OR AC CABLE. �n�� Ii <br />� <br />L � <br />�• CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />' I hereby certi(y lhat I have read and examined this ripplicalion and kno�v the sarne (o be tn�e ��nd <br />� cormct. Flll pravisions o//mvs and o�dinances governing this type oI �vork �rill be complefetl S <br />� �vhefherspecibed I�erFiP ornoL The grantiny ola pemuf does not resume to give authonfy to � I� �' O�l I <br />viofafe or cancel t0�proVisions ol any other s(afe or local l�w m9uPling constructron or fhe �. <br />��Annnanr.e of constnic(ian. TOat I am aufhonzed by tHe owner ol fhis property to pedorm fhe <br />t <br />I �-:v�� i�� �,� �,....,,..,, <br />� 296200 WAC. , <br />I " �'\ <br />, �� . <br />comply �vifh fbe Sfate Confrac ors Law 78.27 RCW and <br />�- �— %2 � <br />Date <br />_ _ — — __� <br />