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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 /> 3co3 � CG,s% ho P j <br /> PROJECT ADDRESS <br /> QCT P 1 n rn <br /> Owner _ _ Mail Address city Stat /Zip Phone <br /> city �a�aiw�iN Phone <br /> is <br /> Tenant Mail Address City State/Zip Phone <br /> gas <br /> o>n v 1 1 Sca S oel S 7 ala- G-C> <br /> Electrical Contractof Mail Address City State/Zip Phone <br /> cbM0 6T1. 9g11 bQ x,100.0 -6 <br /> State License Number Contract Price of Work <br /> F �F\e.5 -4 CQV4�r <br /> Proposed Use of Building Contact Person (Plan Review) <br /> i <br /> l �c7 <br /> Square Footage(If residential new construction, remodel or addition) <br /> I <br /> Description of Work to Be Done: &AX A[. G e SSz ahA-r or &csn p J a =Q)[I S"�"1 <br /> CoGce.SS ron-*y,n` Sfel� +ky, m%' -AJ 1, 0A C&_ D0,Y1k1S' tOV) IW <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> 5V <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that l 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 C—12W —134 <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 this roperty to perform the <br /> work for which pplication is made an I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. / <br /> Si�nat Date <br />