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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org I1--15-4 -2 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM t (J <br />7 Y/ter sf <br />PROJECTADDRESS <br />LdY o-r' rryPre7� 4 3Zoo Crd, sf G vcr��} G✓i� yr?LC7 <br />Owner' Mail Address City State0p Phone j <br />Sul r G A- S <br />Tenant Mail Address City State/Zip Phone <br />1�e 1 Ts�T- ,N%ors <br />Electric6l Contractor Mail Address City Slatelzip Phone <br />N11gT [ O 1- 9 /SKI= f' S. ov c> <br />State License Number // / Contract Price of Work <br />\` )) <br />Proposed Use of Building Contact Person (Plan Review) <br />�"C <br />Square Footage (If residential new construction, remodel or addition) f J <br />Description of Work to Be Done: /Vt' w . r d r VCS �L✓rc� i� r r f jai 1�icC <br />v <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. SO <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming this type of work will be completed <br />whether specified herein or not. The granting of a permit does notppresume to give authority to <br />violate or cancel the provisions ofany other state or local low regulaling construction or the <br />perfonnance of construction. That I am authorized by the owner of this enperty to perform the <br />work for which applicatiun is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Signature Date <br />