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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 C/ �7�077 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />State/Zip Phone <br />'AGO I `-h c <br />Tenant <br />Mail Address <br />City <br />State/Zip Phone <br />/yr— �tiT/ G <br />7 ? O y rf Z!� !� ' L <br />/�vf c5 � / '7 <br />� 7�i4!/G7 •'�•" <br />Electrical Contractor <br />Mail Address <br />City <br />State/Zip Phone <br />'Stalb License Number <br />/ <br />ge'I <br />Proposed Use of Building <br />2/J0 6 <br />Square Footage (If residential new construction, remodel or addition) <br />Description of Work to Be Done: �bC L 5i/C )Qv <br />A. l2/ r r 1_- x Of,V rF,-xx WC3 <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRE) TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the <br />correct. All provisions of laws and ordinances governing this typo of work w <br />whether sperihed herein ornot. The granting old pernrf does not presume <br />violate or cancel the provisions of any other state. -r luca. law regulating con <br />performance of construction. That I am authorizes by fM: owner of this rep <br />work for which application is made and 1 comply with fhct ; tote Contractors L <br />296.200 WAC. <br />S oOv- ,-0 <br />Cot Price of Work <br />Contact Person (Plan Review) <br />to be true and <br />completed <br />re authority to <br />lion or the <br />o perform the <br />8.27 P.CW and <br />'/-,A <br />FEE <br />CIAO}-o-4 �— <br />