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ELECTRICAL PERM-IT 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 /> PROJECT ADD ESS <br /> Owner V ��P Address City State/Zip Phone <br /> 7- LI Y 6 95 <br /> Tenant Mail Address City State/Zip Phor� <br /> ( 3bo <br /> &o..r.v fk f_VA eP tSe2 �- - <br /> _LK �� 2 a�u A l►J 1� �}��?0 (oS3�y3S <br /> Electrical ContractDr Mail Address City State/Zip Phone <br /> 7 OQ oa <br /> State License Number Contract Price of Work <br /> Proposed Use 6f ullding Contact Person (Plan Review) <br /> Square Footage(I residential new construction,remodel or addition) <br /> Deserlptlon of Wo to Be Done: _ e u] �e.ry1 'C Q �e O 1 csQX V t u- <br /> NOTE: WIRIN IN NON-DWELLINGS IS REQUIRED TO PEE <br /> BE IN RACEWAYS,MC OR AC CABLE. <br /> CITY OF EVERE LOCAL SALES TAX CODE 183105 <br /> 1 hereby certify th t 1 have ad and examined this application and know the same to be true and <br /> Correct. All provi iread <br /> of laws and ordinances governing this type of work will be completed <br /> whether.speclfled herein or not. The granting of n permit does notresume to give authority to � <br /> violate or cancel, <br /> d a provisions of any other state or local law regulating construction or the <br /> performance of c nstruction. That I am authorized by the owner of this property to perform the <br /> work for which apblication Is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature! Date <br />