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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 /> ( S c'. , -1 5 b-, 5- _ -- SW , al -c_ - <br /> PROJECT ADDRESS <br /> ir\OVNOkr\(:-AN (U ur\ \ l b Po Bax HD-1 F'v e&+ WA l? ° <br /> Owner Mail A'd ess City State/Zip Phone <br /> St\ol(\br ' ash Co ut D l8u0. .1541 S-�ree.f- Ev e+I- IL)il-R <br /> Tenant Ma City State/Zip Phone <br /> a\" -C,,ti-\C-e— C 0'r\--k—n)1.5 1-0a tet- � `y-1)e `Ti'~1 `Lop- .gI <br /> Electrical Contractor Mail Address Cite State/Zip Phone <br /> ClQTP2 c-i \ 3P7- il /0S- 'J( ' , 1 Co <br /> State/a� License Number Contract Price of Work <br /> /-t-ci r)A_A.,.-, t�U--r. c__o �1 C aG �P ,- C �1 <br /> Proposed Use of Build g Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> Description of Work to Be Done: OJ <br /> '�rn� L b in (3-c- I c uJ \J 00) <br /> CICC.-cSS (`o-f-vc-A c P(''urLp0u'1 __tl./�1l 3 floors <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ob <br /> 5D -- <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 El gQ _ J a, <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 <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 this property to perform the <br /> work • hich t•.ication is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.:00 Ir.,`` <br /> �! Q �, h 1 7,51 i y <br /> Signature Date <br />