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t <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www•everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />2�'�� 1-lo�T ���4E <br />PROJECTADDRESS <br />Ati�wOw�r�se oF' <br />Owner <br />Mail Address <br />City <br />�SID`� <br />Stale/Zip <br />��/� <br />g—DO� <br />2_� <br />Phone <br />�L�ni_��f �y a9t 7 40�3 1-laJe�'�%r �llF'"'=YT qD20� `iLs �44-K"ll <br />Tenant Mail Address City State2ip Phone <br />Elec�rical <br />Mail Address <br />I�� . yrrk .� Do���1J, <br />Slate License Number <br />�7LY��4 ,Ji Lo✓�nT./Ftr�.i* <br />Proposzd Use �f Building <br />Square Foo age (If residential new construchon, remodel or addition) <br />City <br />Stale2ip Phone <br />� �Dc� �o <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work lo Be Done: C� 21.� t G 7iR DG r R OT iJ ' ��L�CPQ �o � �..� T h! iJ AIJI) <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE . <br />.�5�.5u <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hemby certily (hat I have read and examined this appiica�ion and kr.nw the same to be true and � I Z�Q � O�� <br />correct. All provisions o(laws and ordmances govemmg fhis typo o/ work will be completed U <br />whether specified herein ornot. Tho granting of a pennrt does not presume �o give aufhonty to <br />violate or cancel the provisions ol any ofher stafe or/ocal lmv regulating constn�clion or fhe <br />pe�':miance o(cons(ruction. That I am authonzed by fhe owner of this pmperty to peAorm the <br />work for which applicahon is made and 1 comply with the Sfafe Confrac(ors Lew 1827 RCW and <br />296.200 WAC. <br />