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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 96201 �(—bS—/Z <br />425-257-8810 - FAX 425-257-8857 —www•everettwa.org �'� `�q <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />-� •�'.3f G,irt•,..�...a /'}�P <br />PROJECTADDRESS <br />Owner <br />L ✓ilC(/ �ULM. G <br />Tenant <br />Contractor <br />L!%ynrtf� . `tY,S f� <br />Stale icense Number <br />Proposed Use of Building <br />Pdail Address <br />City <br />ZSS� w+'fr»s�r� !{�'� C`�T. <br />Mail Address ���Y <br />f3Zi z.y v��'l�'� � (rr <br />Mail Address City <br />Square Footage Qf residential new construction, remodei or addiliun) <br />StatelZip <br />w✓f y�Zd� <br />State/Zip <br />G„if 9�t.rc Y1.f, <br />Stete/Zip <br />��� �c <br />CoMract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: !i+ 5��� /t/�+.� F'�r ���c`' l �" ��'r- /�f UH ��C <br />NOTE: WIRING IN NON-DWELLINGS IS RECUIR[D TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />that 1 have read and exami.aed this apnlicafion and know fhe same fo be Iruo and <br />roisions o/laws and ordinances govem�,^g!his typo olwork will be completed <br />ed herein or nol. The granhng ol a permrt does nof presumo to give aidhonty to <br />�I the rovisions olany ofherstate orlocallaw regulating consWchon orthe <br />' cons�ruction. That 1 am aufhonzed by flie owner ol thisp ropeRy fo perlorm fhe <br />application is made and 1 comply with Ihe Sfate Contraclors La�v 18.27 RCW end <br />Phone <br />Phone <br />F�hane <br />FEE <br />�� 50 <br />�IZOq - �� <br />