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� <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 � ("� � '-��-�h S�. 5� <br />PROJECT ADDRESS <br />�� �� 1 <br />Owner <br />. � <br />Tenart <br />I � <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />�f �t�P��-� (�� �1 � 3 <br />City <br />City <br />Mail Address <br />��LC�1��1 � �CLo <br />State License Number <br />�Y� c� f �s� [ � <br />Proposed Use of Building <br />V <br />Square F otage (If residential new construction, remodel or addition) <br />Description of Work to Be Done: <br />�=�r'P�(�- <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />State/Zip <br />��� <br />�52Q i� <br />Phone <br />State/Zip �� 5` Phone <br />Z � <br />1 �- ��'�Sz �� � ` 3C� � <br />State/Zip Phone <br />�U <br />�� <br />Contract Price of Work <br />�_ �.��� YYYx.-�-In e v�rs <br />Contact Person (Plan Review) <br />T�Z--t C_C:�-� <br />� C Q �"` l.�'f' T `� �'L <br />CITY OF EVERETT LOCA SALES TAX CODE IS 3105 <br />s <br />I hereby certify that ! hav ead and examined this application and know the same to be true and <br />correct. A/l provisions of 1 ws and ordinances goveming this type of work will be completed <br />whether speafied ein r not. The granting of a permit does not presume to give authonty to <br />violate or cancel fhe p isions of any ofher state or local law regulating construction or the <br />performan e of const�u �on. That I am authorized by the owner of th�s property to perform the <br />work for hich applic io is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.2 WAC. <br />� Zz(l�. <br />Date <br />FEE <br />�� �. �� <br />� <br />�I1�2'� <br />��� <br />