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ELECTRI�AL PERfVIIT APPLICATIOfV <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wv��w.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />`� C� I I� j�� � P� �J <br />PROJECT ADDRESS <br />S�'Ur�B-4J I-vJ �� J i�`iac,� 1NCr <br />Owner Mail Address City State2ip Phcne <br />Tenanl <br />Mail Address <br />City <br />State�Zip <br />Phone <br />S�_,r�r��T E�C��f�a� G�Z��s ^C�IST 5� �l�J ST�N�,n�� :._,A `�`o'L`'i'L <br />Electrical CoNraclo� Mail Address Ciry State2ip ` � � ,� Phone <br />� �� J��S "J���F% <br />��Pr��f11F � Ck�U KZ- <br />Stale License Number <br />' % <br />��' �i'_ <br />Proposed Use oi Building <br />LI(�� <br />Square Footage Qf residenlial new consUuction, remodel or addition) <br />� <br />L=�oO <br />Conlract Price of Work <br />Contact Person (Plan RevievQ <br />Descrip�ion of Work to Be Done: �C� ��� OP�M� �UE-G ���\S�i N(J �n-� I� I f�/�,f <br />PJOTE: WIRING IN NON-DWELLINGS IS RE�UIR[D TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE . �j� �� <br />"I <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 - <br />I Hereby certi(y that I have read and examined this applicafion and know the same to be tnte and <br />correr.f. All prowsions o(la�vs and ordinances go✓eming this type of �voik �^�ill be complefed <br />wHetherspecibed herein ornoL The granting o(a pennd does not resume fo give authonty fo <br />violafe orcancel Ihe pravisions olany otherstate or local lmv myuP(ing cons(n�ction or (he <br />pr.rlomianr.e o(consfnic6on. Thaf I am aulhorized by fhe ownero(this property to pedomi t!;� <br />ivork !or which application is rnade and 1 comply �vdh Oie Stale Contractors La��✓ 18.27 RCW and <br />296.200 WAC'. <br />('S'I Z <br />�12��-02� <br />