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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 c� _ �� _� � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� , � � � <br />�� ✓ (� i1' � � �i �� � � ' � , ' � <br />PROJECT ADDRESS <br />� ,, .. <br />Owner <br />I � ' <br />, �- <br />Tenanl <br />Electrical Coniractor <br />%/Z�-1o�✓ <br />_ ' �, <br />��� �i � `>��Lu p1�L�:.. �1;;�„� ��� � <br />Mail Address City State/Zip Phone <br />; ��-- �� i , <br />t� ; <br />i� „ .... i i , \.,_ _ � <br />Mail Address City StatelZip <br />� � i, � � ,� � _i'� � (,.- , , ���'� �:�.t�ti ��.Jil- � �'. � <br />Mail Address City StatelZip <br />�'r, ,JF� :;_ L—}:.! U�., � � <br />State License Number <br />Proposed Use of Building <br />�S. � <br />r�(,'� ('_,� <br />Contracl Price o( Work <br />Phone <br />�,� ,�„ i <�l`r <br />Phone <br />Contact Person (Plan Review) <br />Square Footage (If residenlial new construclion, remodel or addition) <br />Descriplion of VJork to Be Dane: <br />j� z 1��.�:'k a�z_ l, � ) �. � � � , � , '� '1 , . , °. � r <br />I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />, BE IN RACEWAYS, MC OR AC CABLE. <br />�ICITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily thal l have read and examined this application and know the same fo be true and <br />correct. All provisions o/laws and ordinances goveming this type oI work will be completed <br />I whelher spea/ied herein or not The granfing of a permi( does nof resumo to give aufhonry to <br />violafe or cancel the provisions o/any other stafe or 1oc21law reguPting constn�cfion or the <br />! performance o( construcfion. That 1 am authonzed by the owner o( this property to perform the <br />work for which applicafion is made and I comply wifh the Sfate Confractors Law 18.2i RCW and <br />296.200 WAC. <br />� '�.�-- <br />�_�,; • <br />FEE <br />5� °� <br />-�lZo� - l05 <br />