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ELECTRICAL PERMIT APPLICA710N <br />CITY OF EVERE'iT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www•everettwa.org <br />APPLICATIOIJS ARE ACCEPTED FROM 8 AM TO 4 PM <br />C{�3� �✓i:rc reCn �il,�cx�� .��,�e 11� <br />PROJECT ADDRES <br />—J�lO-IZ <br />�� � Zb 6�I5S <br />r"�c��tiCr9� ��1�`C J.nIC/n�.F,L.�a� ijlt e✓�,�cG•u.�.y�S��.�c t(-IL� C�i�ii� 1�/;. Y�Yzcy �/IS-43S'-%�'�� <br />Owner Mail Address City State2ip Phone <br />Tenanl <br />Eleclrical <br />Mail Address <br />����s �z��� tie 17sr1 <br />o� hlail Address <br />C,�S s �i s-� � ���c,� <br />Stale License Number <br />('.,:,,,,C���<<� �..1F,�� <br />Proposed Use of Building <br />Square Footage Qf residential new conslruclion, remodel or addition) <br />Ciry <br />Cily <br />SlatelZip <br />� �l,�C� %f���'� <br />SlalelZip <br />,� 75U . �` <br />Contract Price of Work <br />Phane <br />yzs ySz- <br />s����r �z.,���5 <br />Conlact Person (Plan Review) <br />Phone <br />Description of Work to Be Done: �- G� a � � � 1' S�c�� C — <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. � oOO <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby cerldy that I have read and examined fhis applicafion and know Ihe same fo be Irue and �� z� b-! 55 <br />corre�t. All provisions ollaws and ordinances govemmg this type o( work will be comp/eted <br />whefher specJied herein or noL The granfing o/ a permd does notPresume to give aulhonty fo <br />violale or cancel the provisions o/any ofher sfaie nr local law regu�aling cons(ruction or the <br />perlormance n/ construclion. That I am aulhorized by the owner ol this property ro peAorm fhe <br />work !or whid� applicafion is made and I compty wifh Ihe S(afe Contractors Law 18.27 RCW and <br />296 200 INAC. ,� <br />�L-..Z� ��z <br />