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ELECTRICAL PERMIT APPLICATION <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 />1 c fA <br />i 1 <br />PROJECT ADDRESS <br />L� c t raw 1� s I Z3 �,9't ?L '5C Lyc a:rr %J/t `JRzo 3 <br />Owner Mail Address City State/Zip yZ5 3y7P�j� <br />Tenant Mait Address City State/Zip Phone <br />owner <br />Electrical Contractor Mail Address City StatelZip Phone <br />Slate license Number Contract Price of Work <br />�7l l CT <br />roposed Use of Building Contact Person (Plan Review) <br />94 <br />Square Footage (If residential new construction, remodel or addition) <br />Description of Work to Be Done: 14ta ' 5�)�'C p Amp fSrw ,\c c _ <br />NOTE WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. .5 0z) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3115 <br />1 hereby certify that I have read and examined this appl,,slion and know the same to be true and r 12 O f ;O <br />correct. All provisions of laws mid ordinances goveminy this typo of work will be completed C J 7 C_s�' <br />whether specified herein or not. The granting of a pelmi, does not prosumo to give authority to <br />violate or cancel the ppenvisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.20 <br />Signalur Dale <br />