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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-88'�0 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�S 22 �S 1S � �1 S� �� �t�z�� <br />PROJECT ADDRESS <br />� �� <br />Owner <br />Tenant <br />� r "+� <br />Electrical <br />S�`�v�ro�� �j�-�.\o � <br />Maif Addres <br />. --- _ <br />Mail Address <br />V��. Se�� vr c,r� oZ�a`l t0 `�Z.`^� <br />f Mail Address <br />.�� \ � Cr �. k `� `� � iJ S <br />State License Number <br />�����h �� <br />Proposed Use of Building <br />City State/Zip <br />C ity <br />� N� <br />C ity <br />i��-< tb �r- 1`12 t� � � ip g� <br />Square Footage (If residential new construction, remodel or addition) <br />��' ��13 �2�� <br />Phone <br />State/Zip Phone <br />��`� �`��D CJ��� <br />'�� "l�Z`l Z <br />State/Zip <br />l Z �v �Z) <br />Contract Price of Work <br />q�v, ���e��-�. <br />Contact Person (Plan Review) <br />Description of Work to Be Done: j�c'�� ���-�-c�,,, �a,., � �� � �v �-��,�+i,� `�� c� � fl,-�Q ��'�i,�,�,� <br />�`��Cv i � � 1 p p t <br />� R Wl�, �� ���1 ��� �. li ��l ��I`-� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO • FEE <br />BE IN RACEWAYS, MC OR AC CABLE . ��� 06 <br />� <br />..�- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that l have read and examined this applicafion and know the same to be true and <br />correct. All provisions of laws and ordinances governm� ihis type of work will be complefed <br />whether specified herein or not. The granting of a perm�t does not presurime to give authority to <br />violate or cancel the provisions of any other sfate or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to peiform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />� <br />�--�-- 1.____ �, � �, , <br />Si4nature . na+A <br />Phone <br />��3��--d�d <br />