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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-881� - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />1 � C� � �O a�-, ��l �-� � �= <br />PROJECT ADDRESS <br />�'��3 IWI�� <br />Owner Mail Addres: <br />o�� � ,�� <br />Tenant <br />� <br />Electrical Contractor <br />'V I �,� '� �'v v� �--h <br />State License Number <br />Proposed Use of Building <br />fVl ,�� �� S�� <br />Mail Address <br />�jIC,� [�i,�l �l� <br />Mail Address <br />�- �� f'O <br />City <br />J/�: �`� i I � <br />State/Zip Phone <br />City State/Zip <br />� �-J � � (V V.� !� l� �"� � �. <br />Square Footage (If residential new construction, remodel or addition) <br />City <br />Phone <br />�-i�l� �.rA �1 �l 11 � <br />State/Zip Phone <br />Contract Price of Work <br />�n ���:�i�P�,� �t�-�- `��3�ss�/ <br />Contact Person (Plan Review) <br />Description of Work to Be Done: �(,y() I��--Q_ -ei� ��T� �C�C� � � C.' h{�_ Vv �'1�'1v11� �C��'Y1� �, <br />� Y \ �� C� ;�✓1 �..- �i � i"C_ , \ `�''C � _:,tyl 1' G.�i^C��; �� J <br />�r- <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />,M <br />CITY OF EVERETT L06AL SALES TAX CODE IS 3105 <br />I hereby certify that 1 have read and examined this application and know the same to be frue and <br />correct. All provisions of laws and ordinances governm� this fype of work will be completed <br />whether spec�fied herein or not. The g�anting of a perm�t does not presume to give author�ty to <br />violafe or cancel the provisions of any other state or local law regulatrng construction or the <br />performance of construction. That 1 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 WA C. <br />r- �< 1 <br />�� � <br />nature <br />FEE <br />��o� <br />� 13�( � l�-S <br />