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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVER�TT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 4�5-257-8857—www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �5c�1 ' � N� I�3�c - 5 - � <br /> PROJECT ADDRESS <br /> ✓)uil�'-�7 �l�.t�v;c�v j ��v- - � n:.� �}�� SC �u�+zc�� C.✓/I ��S.7�tY 'f�,�-3759��7c <br /> Owner Mail Addre,s City Slate2ip Phone <br /> Tenanl Mail Address City SIatNZip Phone <br /> /J Gzo c[ �eV�+�= 1.v9 � `1b�%l} ')� I '���bG✓'i <br /> VC(L71 C LL�� C(I � � ��.��I� "! �'� � � <br /> ElectricalContractor MailAddress City State/Zip Phone <br /> � �S�� <br /> C��.��=FL�IJ� 7�—�7 <br /> State License Number Contract Price of Work <br /> Proposed Use o(13uilding Contact Person (Plan Review) <br /> Square Foolage Q(residenlial new consiruclion, remodel or addition) <br /> DescriplionofWorktoBeDone: �7��� ��('��� � r��t ��C�I� `�u�y� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIR[D TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. [j'�G�j <br /> J�� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I Hereby certily fhat I have read and examined this applicafion and knorv the same to be true and �,._ /� / <br /> coirecf. All pmvrsions o/laws and ordinances govemmg llns type o/n�ork uill be completed C I?I �/� I 7��7 <br /> �shether speci6ed herein er net Tlie r�rnnting nf a pennd does not/vesmne fo give aufhonty to Y <br /> violate orcancel the provisions o/any olher sfafe or localla�v rngulahng const�uchon or the <br /> pedonnance o/cons6uc6on. Thaf 1 am authoiized by(he ownerol this �roperty to pedomi the <br /> �vork lor�vhich applicafion is made and 1 comply�vith the Sfate Con(racfors Law 18.27 RCW and <br /> 296.200 W/lC. <br /> `�"� `�2�-,M ��1�s /�� <br /> Signature Oale <br />