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Jan 22 16 09:36a Vickie <br />� �- �� � <br />��� — �{�3 � <br />3606914838 p.1 <br />�� � <br />ELECTRICAL PERMIT APPLI�GATIOl� <br />CITY OF EVERETT PERMIT SERVICES <br />320p CEDAR STREET, EVERET7, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APRLICATI�NS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��� ���� � � <br />PROJECT ADDRESS �� <br />_._ __._\ <br />S �� ��c�t.-� z-�- I � � ��� �' � �I � ���-i� � t.c.1 �— <br />Owner <br />M <br />City <br />State/Zip <br />Phone <br />_ �� �- Z� z �- 3 �3�' <br />Tenant Maif Address City 5tatelZip Phone <br />L.LJ � �L' C:J C�( � �f,� ._�//�.J� � U �7� �� 6 ��'�B��Itil�j�. �i�''LL.S <br />Electrical Contractor Mail Address City State/Zip Phone <br />3fd� ��� -'�`�3d� <br />_ ��«c��-� ���� � �r�3�c� <br />State License Number Contract Price of Work <br />�� <br />Proposed Use of 8uilding <br />Square Footage (If residential new construction, remodel or addition) <br />,� � _ . <br />Description of Work ta Be Done: <br />NOTE: Wf RING IN f�ON-�WELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />CfTY OF EVERETT LOCAL SAl.ES TAX CODE IS 3105 <br />Contact Person (Plan Re�iew) <br />��'/��j '� � i <br />. �/ <br />FEE <br />��.�� <br />1 hereby certify fhaf 1 have read and examined this applrcation and know the same to be true and ���� �r ��� <br />correct .411 provisions of laws and ordinances governing this type of woric will be compiete�' <br />whetherspeci�ed herein ornot. The granting of a perm�f does notp resume to give authonty to t <br />violate orcancel tfie provisions of any oiherstate orlocal !aw rcgulating construction or fhe <br />performance of construction. That 1 am acitfforized by Phe owner oF thisp roperiy to perform the <br />work for which applicaU'on is made and 1 c�mply with the Staie Confractors Law 98.27 RCW and <br />296.20D L�AC... <br />�-��� . / - �-- % <br />ure <br />