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ELECTRICAL PERMIT APPLICATI�ON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, 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 />�v10 s� P� <br />PROJECT ADDRESS <br />1�(' / � <br />Owner <br />Tenant <br />�� � i� i�� i 1 <br />Electricai Conlractor <br />, <br />>n <br />�� � <br />� ll � ;<��/ � <br />Mail Address <br />Mail Address <br />;� /r �i - � � C <br />Mail Address <br />�� G u r� FL `-�C'%� �� � 3 <br />Slale License Number <br />S - F - 1� <br />Proposed Use of Building <br />/ � �' "'l� � <br />Square ootage (If residential new consiruclion, remodel or addihonl <br />Description of Work to Be Done: �� l L� � <br />,�, :�; � _ �• ,-i. � <br />Ciry <br />City <br />�1���� 1�, <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CA6LE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily that I h��ve read and examined fhis applic <br />correcf. A/l provisions c(laws and ordinances goveming <br />whetherspecified herein ornoL The grantiny o/a permd <br />vio!afe �rcancel the provisions ofany otherslate orloccl <br />performance o(construct�on. That 1 am authomed by Ihe <br />work (or which application is made and I comply .✓i(h the <br />296.2U0 WAC. <br />��� / V L�-t'_/ � l( L�'' (_ <br />State/Zip <br />State2ip <br />City Slale/Zip <br />s� �GJ <br />Conlract Price of Work <br />Phona <br />Phone <br />Phone <br />_� <br />Contact Person (Plan Reviev�) <br />i�'/'�l ����/�L�� , 1 i/� <br />and know fhe same to be true and <br />ipe of woi!c will be, completed <br />not presume to give authonty to <br />egulating cons(ructron or fhe <br />ero/this �ropertyfopeAormlho <br />Contracfors Law 18.27 RCW and <br />i �3 -/ � <br />FEE <br />GjC;.c�C <br />�����j_�;1� <br />