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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERE.TT PERMIT SERVICES <br />3200 CEDAR STFEET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />(l���I �!'c� �� 5E- <br />� -, <br />, <br />�_ ,,.��f- ,�.� ��,�c-�s <br />PROJECT ADDRESS <br />l i,�t,fi ; i r�c: �)r. �'� � � <br />Owner Mail Address <br />Tenant Mail Address <br />��..,,i�ii�n-l�;c�,ti�lr��r;'c �51$ <Sr <br />[IeciricalConlractor MaiiAddress <br />� U�'f �� = �'u�1.'i� <br />Stale License Number <br />/�(. :4C��s �^,�� q � � ) C l.`'C�'�'iS <br />Proposed Use of Building <br />Square Footage (I( residential new construction, remodel or addition) <br />Descri <br />City <br />City <br />Ci�y <br />StatelZip <br />Slale/Zip <br />State2ip <br />Phone <br />Phone <br />�S `-4 <br />5'.3'a' � i5r? <br />Phonc <br />7c�, ,�. <br />Coniracl Price of Work <br />��7i'� ��r�lc� <br />Conlacl Person (Plan Review) <br />� NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />i BE IN RACEWAYS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />I hereby cerii(y thut I l�ave �ead and exmnineJ tliis applicafion and kno�v fhe sanre to be Inie and <br />�:unecL All prrovisions o/ fmvs and ordinances 9ovemmg this 1}�pe ol �vork �vill be comple(ed <br />�,rhelhcrspecdied he�ein or noL The granling o/ a pernut does not p�esume fo give au(honty to <br />viola(e orcancel fhe provisions olany ofher stafe orlocal la�v regulating cons(n�cfron orfhe <br />pe�fomiance o( constnrc0on. That 1 arn aidhoiized by fhe on�ner o/ thrs property fo perfonn the <br />�vork (or n�0ich applicalion is made and 1 compty wifh the State Contr.�clors La�v 18.27 RCW and <br />296.200 WAC..� ,� �� / <br />,, a <br />_ ; , <br />C�Nno,u� <br />I �" � ��� <br />I___ ___—__ _.__ _ _ . _ _ <br />FEE � �` <br />r%s' <br />( <br />E l Zo� - 03Z <br />