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• s <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 /> / 1� 9 rues ki4 fAi - <br /> PROJECT ADDRESS I <br /> Verjrie-y, 13714:1JI � l`�7 /L Z- <br /> Owner MaitAddress City State/Zip Phone <br /> K, 1 ! Al2O4(z o Iil s-e <br /> Tenant /Mail�Address City State/Zip Phone <br /> eel 5r ge--0717; (- <br /> • <br /> 27 1/44 Electrical Contractor Mail Address City State/Zip Phone <br /> RE-Cr ec °�`j 1 t <br /> State License Number Contract Price of Work <br /> Proposed Use of Building C&p act Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> Description of Work to Be Done: 2 0 V1 a�,epokife-r---Fer-- t�` ` ~ bo ,1 <br /> a, 6 Lot- <br /> NOTE: <br /> NOTE: WRING 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 �' ( elkt <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 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 /> /n -7--(7r— L ' <br /> Signature Date <br />