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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 –www.everettwa.org � � g-1 3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PNi C � J�l�D�� <br /> ,?3��c� Mu��=.t�� c�2K �)cv��i <br /> PROJECT ADDRESS I <br /> Owner Mail Address City StalelZip Phone <br /> SZ MANv�'-�c�vi2lr�f Z3c �� n��E221�� vRJ�. Pf��a�� Fv�fL�TS WA. <br /> Tenanl MailAddress City StatelZip Phone <br /> r�\2iz�t2 f�r�Q SicV� i�y LlC I�G07 `S4�� A� niti P2��Nc,T��J WA 4Y2zZ �Iz� 2`i�-I �`��15'_ <br /> Electrical CoNractor Mail Address City State/Zip Phone <br /> r3qrut=F s�, 3i M� 2y v� "� <br /> State License Number Conlract Price of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Square Footage (If residenlial new conslruction, remodel or addition) <br /> Description of Work to Be Dane: �i a.r'_ /J.-n2r, Y �1- <br /> _ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br /> BE IN RACEWAYS, MC OR AC CABLE. FEE I �� 5O <br /> CITY OF FVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 herehy�:eriily fNat I Dave mad and examined lhis application and know the some to be fn�e and � ��O � `v�� <br /> correcL All provisions olla�vs ancl ordinances goveming fhis type of�aork u�ill be complefed <br /> r:fietherspeci6ed lierein ornoL (he gran�ing o(a pernuf does not p�esunm(o�ive authonty to <br /> violate ercancel the provisions o/any o(her sfate or localla�v regu/alin�consWc6on or fhe <br /> perfonnance oI construction. That 1 am authonzed by the avner ol fhrs p�aperty to perlortn ihe <br /> �vork/or�vhich applicalion is ntade and 1 cornply wdR fhe Stafe Confractors Law 18.27 RCW and <br /> 296.200 �VAC. <br /> ' /. "' �� <br /> � . , � i� ;Jts � � <br /> /,�.� � ____l_/_—" � 3 <br /> �Si ture Date <br /> I __ I <br />