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ELEC1'RtCAL F'ERM�T �►PPLICATIQN <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 />� 6 ( �� s -r C� �., r-�� ��--c; �.� � �.�-�¢ t=i , 1,�� ,h- `=T � l.� ;� <br />PROJECT ADDRESS <br />� ve�-e ({ S��wC, � � �-fi�} c�f- i 30�- �Q'��` s�� s�� � �-z ��}- c,��� � 8 � �� � z� � 4-� ��L <br />Owner Mail Address City State/Zip Phone <br />S�Gv� � � �'� �(,� C G� C� � }-� _J . <br />Tenant Mail Address City State/Zip Phone <br />5�--�(� r�2. C�y+�k�vrvCz�t`ctt� �Z3C�` �'�-,;k-; 1ko �.c�v��`�"� lv�.'%I�f� CU� °t��`7� �-Z� 3'��: IS`17 <br />—� <br />Electrical Contractor Mail Addrzss City State/Zip Phone <br />SK L.LCL `�33C��7 <br />State License Number <br />C�zs> �2 c 1� o� �� (� `> <br />Proposed Use of Building <br />� ���� �c <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition) <br />Description of Work to Be Done: -� �^y�`�Clr�� `�I �( C�'�'�� �-c ��� � �j C"�"•��t' C��j t� jl <br />� � � l� <br />c'r-� L� �-E�'�'�_(�'l,� �I'� � Q�.c� Ccr � /,? C � �'�'� ' 1� ���lx'il'`� C�. � �-=� <br />{ <br />NOTE: WIRING 1N NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />CITY OF EVERETi LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that l have read and examined this ap�licaiion and know the same to be true and <br />correct. All provisions of laws and ordinances governmg thrs type of work will be completed <br />whether specified herein or not. The granting of a pernui does not presume to give authonty to <br />violate or car�cel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorizeU by the owner of th�s property to perform the <br />wor!< for which applica is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 C. <br />ll'�---- � � -��-- � L <br />Signature Date <br />FEE <br />�P � � r.!-•_ <br />��c� �L'—�7� <br />ZG_i �JCJd 'bdl^!r� �IlI�IJij TTTh�9rS�b F�T ��=T �`T1=1�'i}�r'_,;'4_iT. <br />