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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERM!'T SERVICES <br /> 3200 CEDAR STREET, EVERETT, VVA 98201 <br /> 425-257-8810 - FAX425-257-8857—vrww.everett�va.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO A PM <br /> Ili � �- Mar�ne �1iPu� �� <br /> PROJECT ADDRESS <br /> I. i n -� - I� . Mur� �., �►'��-f- - I� ��2c�1 `�s 5°� � � � <br /> Owner MailAddress Ciry State2ip Phone <br /> ITenant trla�lAtldress C�ry SIatMZip Phone <br /> AC�, F 1� d ,iC, - l`��I I (Yle►21 I� uN1el I �� �1 I y S� lo I 3 <br /> Eled�icalConVaclor h7aitACdress City Stale/Zip P one <br /> ��T�v F c -�c�� ��s _ � i� G 9� .�° <br /> Slale License Number Coniracl Price of Work � <br /> Proposed Use o(Bwlding Contact Person (Plan Review) <br /> Square Footage(If residential new consiruclion, remodel or addition) <br /> Description of Work lo Oe Done ` 1 I �� � "— ' ✓—���^� I I�� � I �I� J <br /> t c nq � I � ,u i � C��_�a� ' <br /> _ J <br /> NOT[: WIRING IN NON•DWELLINGS IS R[QUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �� �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 ( ' I <br /> 1 heieby ceRdy fhat 1 have read and examined this application and knmv(he same'o bc lrue and � 1 [1 1 � — � �LJ <br /> correcL All provisions o!la�is and oniinances governing fhis(ype ol nork�:dl6e c:mpfefed I � I � <br /> �vhefhcr speci�ed herein ornoL The granfing o(a pemut does not presumc to give aufhonty to <br /> viola(e o�cancel fhe provisions o(any otherstate orlocalla�v m9ulating cons�rucfien orthe <br /> pedormance o/const�uclion. That 1 am authonzed by Ihe ormerol flus properiy to peAomi(he <br /> r�vhich applicsfron�s made and 1 comply n�ifh the Sfate Confraclors La�� 18.27 R�W and <br /> 296.20 WAC. <br /> , l� ' 1 � ��_—.__ <br /> SiqnaWre Dale <br />