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�-I;a1-13� I -- <br />--- —�" <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PEr�MIT SERVICES <br />3200 CEDAR STREET, EVERETT�, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — �vww.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�(� � `-i � � g� �u��f � D <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />Glectrical <br />I''t� 1�e s rs t� <br />Mail Address Ciry <br />Idail Address Ciry <br />Mail Address <br />�o�� ���a3 � -- <br />State License Num�er <br />S n `,( --k.e �.,. I� lJVell�nc <br />Proposed l�se of Building � <br />! Square Footage (If residential nev: consiruclion, remodel or addiLon) <br />IDescription of Work lo Be Done: <br />StatelZip <br />StalelZlp <br />�-a�-�3 <br />C,� 13p� `��6 <br />IS <br />Phone <br />Phone <br />� C.t +L r �T'� tl �/�4 / [.fY �.S <br />City StatelZip �S'�38-�A7hone <br />azS- ?-;t�-691�p celt <br />`7r0ou , °., <br />Conlracl Price of Work <br />Con�act Person (Plan Review) <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL �ALES TAX CODE IS 3105 <br />I Nereby ceRily thaf 1 have read and examined this application and knon� the same to be fn�e and <br />correcl. All p(avisions o/la�vs and orrlinnnces yoveming this type oI �•rork �till be cornplefed <br />���hc(herspeci(ed herain arnoL The granting o/a permd does notp resume to givc aufhonty to <br />violate orcancel the provisions ol any ofhersfate or local la�v raaulating construcLon or the <br />performancc ol construction. TI t 1 am authorized by the o�vnei o(thisp roperty fo pedonn the <br />i �vark lor �vhich apP��cafion is mt�e and 1 comply �vifh the Sfate ConVacfors Laro 18.27 RCW and <br />— �s =-i3 <br />� <br />FEE <br />- �50� <br />��3d�-13�, <br />