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\J <br />� <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 />1 u C� � '-��-`ih S-�• �� <br />PROJECT ADDRESS <br />�io <br />Owner <br />.�- <br />Mail Address <br />Sf �v���-�4- 4��- <br />City <br />State/Zip <br />Tenant Mail Address City State/Zip <br />Electrical Contractor <br />Maii Address <br />�LLc'���i � �Cl� <br />State License Number <br />�Y� c� ��5� � . <br />roposed Use of Building <br />V <br />Square F otage (If residential new construction, remodel or addition) <br />Description of Work to Be Done: <br />�l('�?�4- <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />State/Zip <br />3 � �, <br />Z52��1� <br />Phone <br />��5` Phone <br />Z � <br />�� �P � J� T <br />Phone <br />�U <br />�� <br />Contract Price of Work <br />�_ � ��� YYI�--�Inev�rs <br />Contact Person (Plan Review) <br />. �. ¢' L T2'� f_�— ( <br />CITY OF EVERETT LOCA SALES TAX CODE IS 3105 <br />s <br />1 hereby certify ti�at 1 hav ead and examined this application and know the same to be true and <br />correct. All provisions of / ws and ordinances governing this type of work will be completed <br />wl�ether specified ein r not. The granting of a permit does not presume to give authonty to <br />violate or cance/ the p isions of any other state or local law regulating construction or the <br />performan e of constru on. That 1 am authorized by the owner of this property to perform the <br />work for hich applic io is made and I comply with the State Contractors Law 18.27 RCW and <br />296.2 WAC. <br />, I z �'� <br />��. <br />J't`L,�{' T� -�Z.` n <br />FEE <br />�� � �% <br />�I 1�2'� � � <br />� <br />� <br />