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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEttETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�Dlo s � C✓erx�i} �Ia�l �Uy �rDn <br />PROJECT%1DDRESS <br />Owner <br />�� lncl�•�fljc: � P.4 <br />Tenant <br />56:�2Pr::�- l e.cGincfr� <br />Eleclrical Contractor <br />Soa;l�RT�F33Z 2 f <br />State License Number <br />� ��1..�[� <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />/Ci2/ E: e,i <br />Mail Address <br />3 0��� '1- <br />Square Footage (If residential ne�n� construction, remodel or addilion) <br />Ciry <br />Ciry <br />� �� z <br />City <br />Slate/Zip <br />Slale/Zip <br />tU�Q �� <br />Stale/Zip <br />�Z /O`�Z <br />Lc/2i� -O�ll <br />� 3�, COD <br />Contract Price of Work <br />Phone <br />Phone <br />yss S�o . r s <br />Phone <br />Contac� Person (Plan Review) <br />DescriptionofWorkloBeDone: Cn����uh�cn�'��� C�'��J �.t5�'n�/R"�ic.� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CAI3LE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 31D5 <br />I here6y certily that I have read and examined this application and know the same lo be t�ue and <br />correcf. All provisrons of laws and ordinances govermng this type of �vork wd/ be compfeted <br />�vhetherspecified herein ornof. The gran(ing o(a permd does not resume fo give authonty to <br />vio/ate or cancel the provisions of any o(herstate orlocal faw reguPfing construc6on orthe <br />pedormance of cons(iucfion. ,That I am authonzed by tlie ownerolthis properiy to pedorm the <br />work for which application is made and I comply wifh the State Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />�� �^ <br />/1/7 �,, - !z-ia-/� <br />,. � V: C{JZJZ�� �I <br />FEE <br />B�2c�- Ci2� <br />