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• <br />ELEC1'RICe�L PEI�MlT �4PPLIC�4TION <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 />,,_� c_i Z� ����/1/�� YZ� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />� � �J.�U J' C �,� � <br />Electrical Contractor <br />V� � <br />Mail Address <br />Mail Address <br />V.' -;� <br />Mail Address <br />C�.UrL� �ZZ�� <br />State License Number <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Description of Work to Be Done: <br />� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />City <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />�� C"�� v�..� t.,�,�'�- ��Z-� l <br />City State/Zip Phone <br />� `� <br />Contract Price of Work <br />Contact Person (Plan Review) <br />v �JG�I � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that l have read and examined this application and know the same fo be true and <br />correct. All provisions oflaws and ordinances governm� th�s type of work will be completed <br />whefher speafied herein ornot. The granting of a permrt does notp resume to give aufhonty to <br />violate or cance! the provisions of any otherstate orlocal law regulafing construction or the <br />perfo�mance of constnictron. That I am authonzed by the owner of fhis property to perform the <br />work for wf�ich a,q� lication is,/n ade and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. l \ (' <br />Signatufe <br />0 <br />FEE <br />� � �-,��._ <br />