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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98?.01 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />6-os-i2 <br />Er2os-r57- <br />���--� �t--`tiZ�� Q%,� �e1 fl-�—� <br />PROJECT ADDRESS <br />A-�-OC25o^.% S fiz��'P�.�G 33� 5 <br />C��t,t�.l�— (, LG Po 6 3Glv Z����i� t,�-n �'i B a�3 ._ <br />Owne� MailAddress Ciry Statefiip Phone <br />JaGG{M-"� <br />Tenant Mail Address City State/Zip Phone <br />�"�l. i tiJ l'-lZ <br />EleclricalContractor MailAddress City State2ip Phone <br />State License Number <br />Propo ,e��ing <br />Square Foolage (If residenlial new construction, remodel or addition) <br />����^ � `�0� <br />Conlract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: -�' �`"�i�� l� L� _�� �L� L� -�''v `v�" � �^ �� �� L — <br />C A-4� LL; A-� (L .I_�� ��S <br />(tl— -�-1L� - <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerfify that I have read and examined this application and know the samo to be true and <br />correct. All provisions oi laws and ordinances goveming this type nf work will be completed <br />whether specified herein or not. The granting cf a perm�t does not presume to give authonty to <br />violato or cancel the pmvisions of any other state or local law regulating construction or the <br />perlomiance of construction. That 1 am authorized by the owner of this�roperty to pe�form the <br />worlr for which application is made and 1 comply with 1he StAte Contractors Lew 18.27 RCW and <br />296.200 WAC. <br />FE �� 5� <br />��ao5- �sz <br />