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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT RERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ia-ia <br /> 425-257-8810 - FAX425-257-8857 -www_everettwa.org � '- <br /> pPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ����� ��� <br /> ��ll) �-�'�MMFP.Gi A�..__�✓v <br /> PROJECT ADDRESS <br /> O� h.0 �.t �'R �f�I�-�-I< �—�•�r�� C �. Sti'�7�-1DM�tc� C(RoZ90 <br /> � Slate2p Phone <br /> OW nef Mail Address C�ty <br /> Cit SlalelZip Phone <br /> Tenant Mail Address Y <br /> Cv�>> <br /> ' K� rz�<��+v� `(g033 i1�83i <br /> '� r �t �� a� ���GR�47lnrJ �831 I��� <br /> Electrical Contractor Mail Address Cny <br /> State�Zip Phone <br /> � s �� ��tc 9�9� ��,C� � <br /> State License Number � Coniract Price of Work <br /> � ( �Gz S' � <br /> -��f ���-v« Contact Person (Plan Review) <br /> Proposed Use of Building <br /> Square Foolage Qf residential new construction, remodel or addition) <br /> i1 R — <br /> Description of Work to Be Done: ��� A�'"t� <br /> lic � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />, I hereby ceitily that 1 have read and examined this applicafion and know the same to be truo and ��-7 _;-1 /� <br /> correct. All prawsions o/laws and ordinances goveming this type of�vork�wll be.completed T v—L <br /> �vhether specdied herain or not. Tlie granting o/a pemut does not presume to give authonty to <br /> violafe orcancel fhe provisions of any ofhersfate or local lmv rogu!<�ting consWc6on or the <br /> perfonnance oI cons(niction. That 1 am pufhonzed by Ihe owner ol thisp roperty to peilonn the <br /> work for which application is made and 1 compty tvdh fhQ Stafe Contractors Lmv 78.27 RCW and <br /> 296.200 WAC. <br /> �� <br /> �,�-� � � c�" �J�`/ ,� ao ��. - <br /> Signature Dale <br /> �____ _ ____ - <br />