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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 /> j 8 ol- 75 ryST S w. Y4:12C rT-, <br /> PROJECT ADDRESS <br /> T. U . 7 i a2- 7 5 f s r. mow. 14-1/*2Err <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> ZOOtoC1 eT"A'I E N.W. 5.,40WA f 98tH (,Zoto Q�lo-$980 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> l vis TEc- �8 L o z,Z 14— <br /> State License Number Contract Price of Work <br /> P4 VZ_ f7 UC/./-, <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: l.yS rs4 L c_ J <br /> ��fn 4 hoz <br /> NOTE: WIRING 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 /> 1 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 <br /> whether specified herein or not. The granting of a permit does not presume to give authority to f <br /> violate or cancel the provisions of any other state or local law regulating construction or the ( A ;�_ L1 3 <br /> performance of construction. That/am authorized by the owner of thisroperty to perform the <br /> work for which application is made and/comply with the State Contractors Law 18.27 RCW and <br /> 7296.200 WAC. <br /> Z •ZC. • /Z- <br /> Signature Date <br />