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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETr, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> / a/S L J�t-1131�R D � ��'_ <br /> PROJECT ADDRESS <br /> S�1a= 1;HY /�IS CCti11�Hl2�� IjV�. v—' S' 3yy 73�3 <br /> Owner <br /> Mail Address City Slate/Zip Phone <br /> Tenant <br /> Mail Address City State2ip Phone <br /> �� `(>iuiY i Gc�i�ic. �oi �1C .3�i5 �nu��� �� �-� �U�t �'� ��,1 �IZS -25z� Yb9� <br /> Electrical Contra�dor <br /> Mail Address Cdy StalelZip Phone <br /> /V�( � l i..��" l-U�% 3 f��'� Conlract Price of Work <br /> State License Number <br /> 5��� Contact Person (Plan Review) <br /> Proposed Use af Duilding <br /> �g�C) �I`CI <br /> Square Footage(If res'denllal new construclion, remodel or adddion) <br /> Description o(Work to Be Done: IJd lRi i) i T(�l.lk1" �� V��'��G �� - �'� ��`�� r-r='��>�'Z � <br /> � +�i) ��.�.il GIL) 1��r f �1 •i i u 3 i �, (�r�R;a-L� . <br /> II NOTE: WIkING IN NON-CWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. /�� � <br /> . � <br /> ; CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y that 1 have read and exmnined this application and know the same to be tn�e and '^ I / �_ <br /> correct .411 prov�sions o(la�vs and ordinances goveming th�s type o(work will be completed L I � �.)( �`�� <br /> whe(herspecilred herein ornoL The granhng of a pernut does not resume to give authonty to <br /> I�' violate orcancel fhe provisions o(any oiherstate orlocal law reguPting constniction orthe <br /> Iperlonnance ol construction. That i am auiho�ized by fhe ownerof this property lo per(orm the <br /> woik for which application is made and 1 comply ivifh lhe Sfafe Contrac(ors Law 18.27 RCW and <br /> � 296.200 WAC. <br /> I � � �� i - i �- �3 <br /> S naWre Date <br /> ✓ <br />