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E�ECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-88t0 - FAX 425-257-8857 —www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />(p'� � % � � C . i � 1 �/'L �'� <br />PROJECT ADDRESS <br />Ownef <br />Tenant <br />Mail Address <br />Mail Address <br />� kS.J r,� ; 1 Qy 7� U�: <br />d Conlractor Mail Address <br />City <br />S ?�n�-�-- <br />nt; <br />i 9 � w`-� � " ��' <br />Cily <br />�l�c �--� � 7 �� �� — <br />Stale License Number <br />`_� (� <br />� �- <br />Proposed Use of Ouilding ' � <br />Square Footage (If residential new construclion, remodel or addition) <br />d.- <br />Descnption of Work to �e Done <br />NOTE WIRING IN NUN-U4VELLINiiS IS REQUIRCD TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />State�Zip <br />Sta�elZ�p <br />Stale/Zip <br />c�UG' �'�_ <br />CoNract Price of'Nork <br />Phone <br />Phone <br />zy z <br />Contact Person (Pian Review) <br />I <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />I herr.by certdy that / have road nnA ernmined this opplicafion und kno�v fho same fo bo I�uo and <br />correct All p�ovisions o! la�vs nnd o�dinnnces goveming Ihis type o! �vork will be completed <br />whetlier specil,'ed hercin or nof. 7he rp�nhng ol a prnnd does nof presumn ro c�ive uuthonty fo <br />vinlale or cancel the p�ovisions ol any othr,i sfate or locol Inw regulntiny construction or fhe <br />pmfonnonco o/consfrur.fion. l htil 1 am tiufhoiizeA by Ote uwner ol flus property to peAomr the <br />wo�h /or which npplicalion is made mid I wniplY with (ho Slafo Confracfors Lnw 18.27 RCW nnd <br />296 200 WAC. <br />' . �,� �. �_-- <br />1� � <br />,� <br />� <br />L� c121-v � <br />FEE <br />SO- DD <br />�130i-�';'� <br />