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ELE�TR��AL PERMIT APPLlC/�TION <br />CITY OF EVERETT PERMIT 5ERVICES <br />3200 CEDAR STREET, EVEREl-i, WA 98201 ,3---�( `�3 <br />425-257-8810 - FP.X 425-257-8857 — www.everettwa.org ��.3� 3_��� <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />� � <br />r ���� ')C= ��•�✓'-="i; )^✓'�.�� ��t�� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />�Our-� � ,'��t� <br />Electrical Coniractor <br />Mail Address <br />�r <br />Mail Address <br />zaf� } <br />,Tvtail Address <br />N( v�►�-� �� O ll� � i <br />Stale License Number <br />. � <br />�_�;�nfry� �Y�,4 � i <br />Proposed Use of Building <br />Square Footage (If residenlial new conslruction, remodel or addition) <br />City <br />City <br />Ci�y <br />SlatelZip <br />State2ip <br />StalelZip <br />.� � ��7�� .� <br />Conlract Price of Work <br />Conlact Parson (Plan Review) <br />Phone <br />rnone <br />Phone <br />Descriplion of Work to Be Done: ��7G'�) G��� L��F7 � Sv ��.�✓�� S�� ���LJ <br />�-� �O I !I / P C - ! �✓ — <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />� BE IN RACEWAYS, MC OR AC CABLE. <br />I <br />I qTY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />'�� I Aereby ceRily that I have read and examined this applicafion and <br />'�� correcL All provisions o(laws and ordinances yovemaig this type <br />� n�hether speciGed herein ornoL The granfing ol a perrnd does nof <br />violute orcancel the provisions o/any ofher sfafe orlocal law regu <br />pe�fonnance of constn�chon. That 1 am aufhonzed Gy the o�vner o, <br />.,,..a, r,..,.,i,s��, �,,.,r,�N;�„ ;� ,,,,dn/�nd I comolv with the Slate Coi <br />296' 200 }yA� -/ J� <br />/ t /, <br />� A � <br />4 <br />Siqnatur <br />o�v the same to be tn�e and <br />work will be completed <br />esume fo give authonty to <br />ing conslruchon or lhe <br />iis properiy to peAonn the <br />�ctors Law 18.27 RCW and <br />._ .� . � 3 <br />� <br />FEE ��� <br />� <br />�=1303-0►8 <br />