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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 /> (9 0 1064-h,sr S, E, F v eA. tt W4 98 dg <br /> PROJECT ADDRESS <br /> A- A &m ,cA.//7te- Or/it <br /> Owner Mail Address City State/Zip Phone <br /> SFAt milcit er'_t N t e_ I ct 0 /00-IA, Sr S E, F tl e&C.77 LI/A- 7&Zo r q2S 3/2. 0202 <br /> Tenant Mail Address City State/Zip. Phone <br /> dY\-e:t-a.oeoctr FceC74Ko-C e0 1107 gg5-7. L 64 5-1-- 1/4/3 J eA'TTCe/ WA-. r /0Q. <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> IIY1 : 4 /Z 4,S , 0 GOO- 00 <br /> State License Number Contract Price of Work <br /> lLANtC /IF-r—Pic <br /> Proposed Use of Building Contact Person (Plan Review) <br /> ,25C2 <br /> 5F <br /> Square Footage(If residential new construction, remodel or addition) <br /> Description of Work to BeDone: O Q---t C e �P L 'C'entOt ( °1 d d wALt-S <br /> 1p.(.C.c0 - z fe s DOOe , Q.�- Post—to- ?C,c.trs-S if.. lbA--rA Adci Z <br /> L-r- Sw. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC"CABLE. <br /> ifq 7.5 O <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 �� _. <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 law regulating construction or the <br /> performance of construction. That I am authorized by the owner of thisroperty to perform the <br /> work for which appli tion is made and!comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> /:NE -/3 <br /> Signature Date <br />