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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE�T, WF 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ' Ic� � �o �uC�c/'e� � l9�� <br /> � �e�,r � <br /> � o��z - , ��., �,;� S � � � R82��8 <br /> PROJECTADDRESS a5� , ��6� �a�� <br /> L. e�v��- (--{c�rmeS - f 2��S��ua� �c�', Pu.v�.flk,� (�t��-t�3�3 <br /> pwn6r MallAddress City Statel ip Phone <br /> 7enant �� MdIlA0G�96S City State2ip ���L/ Phone <br /> ,3(�D- ZS� <br /> �r�eus?o � ��ecfi� � c - �ZbS �m���e(d 5fi��',�ucM ac.�,t� Q�(72Z <br /> Electrical Contrador MeilAddress Ciry s�ste2ip Phone <br /> �►�c � e��.��kLS 2� � � <br /> State Licensa Numb¢t Contrad PricC Oi Wo k <br /> �C�u� St ✓�G�e-�clwu�� I�CS 7C�.4:V�CC <br /> Proposed Use of Buil ing Contad Person (Plan Review) <br /> Square Footage(If nesldential new construciion,remodel or addition) <br /> Description af Work to Be Done: e � �Q �� <br /> NOTE: WIRING IN NON-DWELLINGS I5 REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � `� <br /> U <br /> CITY OF EVERE'fi LOCAL SALES TAX CODE IS 3105 <br /> f hereby cedi/y thnt 1 have read and examined N;;s applicn6nn and know the same to bc Lve and <br /> cort�ct. AII provisrans o/laws end ordlnences goveming fh�s type o/woAc wlll be complated � r.Z r O _ OC ( <br /> whether speci6ed herein or nof. TAe grenfing o/e pemnt doea nofp�sumo to give aothonry to � � J l p <br /> violate or cancel fhe provisions ol any otherstate oifocallewrepaleting consfnrcBon orfhe ( <br /> performance ol conshuction. That 1 em authorized by the ownero(this�roperty fo porlomr U�e <br /> work lor wbich app��catlon is de and I compty wltti Me Siate Cantroclors Law 18.27 RCW and <br /> 296200 AC. <br /> �{ /D � /2 <br /> Slgneture a� <br />