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Jan 21 16 10:57a Vickie 3606914838 p.1 <br /> /A` i • /, -/ <br /> f. ii 4 ' -A dr i=740 <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.ora C ) /0 0 13� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM / a� �� <br /> 1?; CDC bPts ' <br /> PROJECT ADDRESS <br /> .---FA-T-Oir-__ Ci, 1 I t.)-(2--- 93D 0_,D160‘ Eve-64-:4 • 1-dA 9e_,AD/ <br /> Owner Mail Address Cit State/Zip Phone <br /> qa,5—,93 —.53°3 <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State!ZIp Phone <br /> State License Number Contract Price of Work <br /> I <br /> Proposed Use of Building Contact PersonR Review) <br /> ( e iew) <br /> Square Footage (If residential ew construction, remodel or addition) <br /> Description of Work to Be Done: <br /> NOTE WRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE . G° <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ' it , <br /> I hereby certify that I have read and examined this application and know the same to be true andS <br /> correct. All provisions of laws and ordinances governing this type of work will be completed t I <br /> whether specified herein or not. The granting of a permit does not presume to give authority to 'el 1 (C <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That l am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAG. <br /> — 111)6_36-0--le...)(-0- - YL ( -—OR I—f . <br /> Signature Date <br /> 1 <br />