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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �`iz <br />3200 CEDAR STREET, EVERETT, WA 98201 g��- <br />425-257-8810 - FAX 425-257-8857 — www everettwa,org C �}Qg ,�� 3 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />I � 81� �2�=� sT s� <br />�, PROJECT ADDRESS <br />'�; �vtr �a�e E��s��lC lel6 �2�'srrE E�.r�- �f� q���s <br />IOvmer Man nderess C�ty state2ip <br />%-I1 1816 I�.� STS� <br />Tenan� Mail �dAmss <br />���,� � �� �60� <br />[ledrical Conl� MnJ n ress <br />', �Ue �cr- SCo i z c`i <br />� Slate L�cense Number <br />Co�v, 5 �� f e <br />, Prnposed Use ol �wlding <br />Ev-ese�- �..� �- <br />(:Ily <br />�i s2c_,r� <br />Statc�Lp <br />Qq S. IMu�.�.T �etu,,,.. �-.,(} q9273 <br />Phone <br />Phone <br />C��y Slnlc ip �'none <br />3�ooy24- �325— <br />100 � <br />Contract Pnte ot Work <br />3�t1 ly�,c � <br />Contact Person IPlan Reviewl <br />Square Footage (II residential new construction, remotlel or adddion� <br />�' Descriplron of Work to Be Done � <br />l�s t•aM ��,a.0 S r y� - <br />NOTE WIRING IN NON-DWELLINGS IS REOUIREO TO <br />BE IN RACEWAYS. MC OR AC CABLE . <br />CITV CF EVEREtt LOCAL SALES TAX CODE IS 7106 <br />I herofrp certAy (hnf 1 have r�rad nnAo+arnmeAfhis »pphcabon anA Ano�v fhe same lo he Vue and <br />corrocf All prows�ons ol laws and ordmancns �overnmg (his typo o! work wdl bo completed <br />�vhethr.r speci6nd heiein or nol Tha �ran6ng ol n pennd does nof (nesume lo grve nufhonly fo <br />wolafo or cancol Ihe (vnvrsions o/ any othc� sfafe or local law �e9ulahny cons!rucfron o� flre <br />perinrrnance ol mnslruc6on Th�! I arn aulhonzoAby the ownei ollhis PropeHy f� perfo�m fhe <br />wn�h lor which apphr.nfion is nradr, nnA 1 cnnrply with Ihe Sfafe Conhar.lors Lew 18 27 RCW and <br />.96?00 WAC <br />�l7-t'�l. "�( M � - z U - ( !� — <br />FEE <br />D� <br />`� � <br />��Z L>�S " � �� <br />