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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 1y-api--NV <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ,. 1?,I j <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> t ao- - t44o -S3 <br /> • <br /> �a/ k - /-/al F,v-9.S-// <br /> ,Y063 th''sr40 //Yd 2/ e!/er,....G <br /> PROJECT ADDRESS <br /> -"?.6e.,v d <br /> Owner i Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> /-1 4 G /C_ Fox 79? /19/1-10/1//e-- 9Y270 360 -6Sg °sof <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> A 770_ *:.35-68 ----- V—CO 0 <br /> State.License Number Contract Price of Work <br /> , 7Aa'H 122,,Ey <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) S • <br /> Description of Work to Be Done: --- ' /-^ - j' 1 /4' L 36i 4c/ <br /> CaI ZGr3 GA/ >�e t` 'T6- 3 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> If0 ;"---t) <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed C1501 —l <br /> whether specified herein or not.. The granting of a permit does not presume to give authority to <br /> violate or cance ' •visions of any other state or local law regulating construction or the <br /> perfo v- onstruc 1 That I am authorized by the owner of this property to perform the <br /> we for., hich a'plication i made and I comply with the State Contractors Law 18.27 RCW and <br /> 2-6.20aWAC. <br /> ® c <br /> mature: Date <br />