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�� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �`� �_� z <br />3200 CEDAR STREET, EVERETT, WA 98201 „ <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org �,�� z0 6-P"I <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� 71(�7 �n f� i'�V'�i � /-� V � - <br />PROJECT ADDRESS <br />,O L v �v�, <br />Owner <br />i. <br />Tenanl <br />Mai� Address <br />Mail Address <br />\'� L <br />City <br />City <br />State/Zip <br />Phone <br />Phone <br />��J�M�+•+� CLE.i,t-cc�C�/tL <br />SF�- ,�,� i�vL !�'� 5 �i�p�s[ Li1iCFSTJ%r�' Lv%�I�IbZ�E (��2si2s�i-cr.,i3 <br />SlatelZi Phone <br />Electrical Conlraclor Mail Address Ciry P <br />ir����vc5���z�� <br />State License Number <br />5 �-� <br />Proposed Use of Building <br />Square Footage (If residential new construclion, remodei or addition) <br />� z sv <br />Conlracl Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: �n.�,'ri �� iu Ew c.�2c.v Z'S SG � A,�-� A w�+—��� �yv� <br />���i lc P (�� �" <br />: <br />0 <br />v12 � cS� ]Z <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. �G C`A <br />J <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerii(y that 1 have read and examined this application and kno�v the same to be hue and � I� O/' _, bG�' � <br />correcL All provisions c/laws and onlinances c�avenung this type ol �:ork will Ge completed l(J � <br />whelherspecificd herem or noL The granting ol a pemuf docs not presume ro give aufhonty (o <br />violate or cancel the provi;ions o(any otherstqte or IocaUmv regu/afing construction or fhe <br />perfomiance of consfn�c6on. That I�m aufhonzed by the o�vner oI this p�operty to peAonn (he <br />work /or �vhich app6cafion is made and 1 comply with (he Sfate Contractors Law 1827 RCW and <br />296.200 WAC. <br />� i / <br />��F'c�l• � �'-�j'� � � �t <br />IZCJ <br />