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i <br />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 PIM <br />PROJECT ADDRESS <br />ra.r+c..'r )5LS fit" ST SX4 1P ZOU 1� Eta ri <br />Owner Mail Address City State/Zip Phcno <br />A,s A-S Ara ovE <br />Tenant Mail Address City State0p Phone <br />I've.S•ZZr"5r k3. (1s�SS <br />zej7 j, a Liccry c <br />Electrical Contractor Mail Address City Stattee/IZip �Phono <br />�( / 006 <br />C Fq TACK i� 7 7 z w mil' <br />Slate License Number Contract Price of Work <br />l 1ft. c4c-1n-L- <br />Proposed Use of Building Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition) <br />Description of Work to Be Done rf DD �I i r 70 V DP.'3 c a u v . �. n w Fv «' G r1 5 %/sArEr2�' ) � Z0 V i�E.'3 c a 'W'_r. a �.r Fv « r, i/tArEi2_ <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. 7� 5Q <br />i <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />hereby certify that 1 have road and examined this application and know the same to be true and f 1.3I O — 1D! _ <br />correct. All provisions of laws and ordinances governing this type of work will be completed C ✓ 1p <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local low regulating construction or the <br />performance of construction That 1 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 />296.200 W C. <br />i /0 rd /to <br />Signa u Dole <br />