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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 />3 %2 � �`�r�,��w�r --���,-.� zo / <br />PROJECT ADDRESS <br />v�JEJ�,E2.t/�/,�i %�'Di(%r�t �n,Got�� <br />OWner Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />C ity <br />State/Zip <br />Phone <br />?'2 S <br />�if �tJ �% �D L�r,.�c%2 i � L��•J/rr.�To,r/s 5`3�/ S�,—.v,Z �/-�d� �'d�`.�'i% �� �'"1y2�� � > � - 9�/ <br />Electrical Contractor Mail Address City State/Zip Phone <br />G��vir���,r�G�r� <br />State License Number <br />%��'D�G�< l��'Fic E <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />'��v��jv � <br />Contract Price of Work <br />Contact Person (Pian Review) <br />Description of Work to Be Done: �/v/D:t L-J�%J'-�i�S Uo�"�'iG!1�z�L�o �zA� ��o'���'l�/ <br />T <br />� �.fi[� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />FEE � <br />� g� s� <br />1 hereby certify that 1 have read and examined this application and know the same to be true and �� ZD �_ r� <br />correct. All provisions of laws and ordinances governing this type of work wiN be completed l <br />whether specified herein or not. The granting of a perm�t does not resume to give authority fo <br />violafe or cancel the provisions of any other state or local law reguPting construct�on or the <br />performance of construction. That 1 am authorized by the owner of fhis property to perform the <br />work for which application is made and I corp ply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. , / <br />z � �� <br />re <br />