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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ----)-17- <br /> 425-257-8810 <br /> —)-1Z425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> t4L t Ada.M A-v- <br /> PROJECT ADDRESS <br /> Carr4 Lc fa A4/.t L1 d e. 5 AA 6 Ve i/l,AeL. g9Z�2 426-418,5),5-2_- <br /> Owner; Mail Address City State/Zip Phone <br /> /v/ t f <br /> Tena Mail Address City State/Zip Phone <br /> 7 OW/q47 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage (If residential new construction, remodel or addition) <br /> Description of Work to Be Done: i V' <br /> 11a? <br /> avV <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> QCITYBE IN RACEWAYS, MC OR AC CABLE. 6(0 <br /> °(2— <br /> CITY <br /> 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 G 1,10q - 03'2 <br /> whether specified herein or not. The granting of a permit does not presume to give authority to l.. <br /> violate or cancel the provisions of any other state or local law regulting 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 /> iiiter- id Wi dPL__ <br /> k "...Hie <br /> Signature !Date <br />