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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 />�� � �y 1� C� S � � G5 /�-�1�. ,a t..�—P � �F' l_-= � <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />State/Zip <br />Phone <br />���J � L � <� L/ 7 (� P`�,�j /{—�C`.k_ I C_c�-*i � -� `�� .1 �� E,-�• <br />Tenant Mail Address City State/Zip Phone <br />� -----/ , <br />��'��' !'�" �L� (��C "'2' l � �� � � <br />Electrical Contractor Mail Address <br />, <br />���-'C� l �� �� ��'��� � � .� <br />State License Number <br />� ��� �� - � � <br />Proposed Use of Building <br />f�'� t�S` �- %Y 1_� � �'�l�_'(j �'S�'C l,� <br />City <br />Square Footage (If residential new construction, remodel or addition) <br />� /� <br />Description of Work to Be Done: C,� 2� � � L_C �-- `� <br />ti <br />1 �l i \ il�.'�..,ti . �� �. <br />`�G��c� L. <br />State/Zi Phone <br />pr�`S� �?�c���-Zz � <br />`_ J �� J`/ •, ���.. <br />Contract Price of Work <br />Contact Person (Plan Review) <br />l -- <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. �� .� R <br />V <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify fhat 1 have read and examined this application and know the same to be frue and <br />correct. All provisions of laws and ordinances govemm� th�s fype of work will be complefed <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 siate or local !aw regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform fhe <br />work for which application is made and I comply with the State Contractors Law 98.27 RCW and <br />296.200 WAC. <br />r____ _ _ __ �_,__...,� <br />u re <br />/�' l'� � z <br />Date <br />