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. • <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 /> 7i 4euctot /vi may, r, IAM 0-43 <br /> PROJECT ADDRESS <br /> • <br /> perve- T?s' eefi iz• N u1Y. ;u, ewe( 24.334.segy <br /> Ow eri r Mail Address City State/Zip Phone <br /> IUB WOOD l 78(r mit wY , v Tr, A , qf2ar 244.4144171 <br /> Tenant Mail Address City State/Zip Phone <br /> Aitt IN' 516N 2-Z Th left4 Sr. , &ri tom. 4i-z` <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> bkik([ 5033 7S <br /> State License Number Contract Price of Work <br /> ?.c-r. e._ (AL 264 67q4PO4 <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: TiosTk1L 0Ai4 ' fJ I V!Dot- b 4r <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> 50€` <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that I have read and examined this application and know the same to be true and E I a0g- 1�. <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 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> p,•riV21/24a/2- <br /> gnature Date <br />