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- -- -- �— -- — -- -- - — � <br />�------- -- - ------- --- -- —� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF �VERETT PERMIT SERVICES <br />3200 CEDAR STRE[T, EVERETT, WA 98201 <br />425257•8810 - FAX 425-257-8857 — wvnv.everettwa.org <br />. � 31S � ;,�,� � <br />PROJECT ADDRE55 <br />Owner <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />5� Sr , � E�'e�e-�t I.J� ��o) <br />� <br />Mad AaCress <br />Crty <br />SlatdLo Phone <br />I h9^IICrs,.K Pi� StaP I�i5a13�nC� S�4 5� rcereii� Wq5qBZ01 �-25 P^ L33� <br />�r,ne�'�r��'lc.�m`Eva.� �rr� 15400 �J�.��Q_ �.�� �`�111�VL�OOLI �^�i� ��0�/�1,5��i2.N� <br />I Electncal Contractar Ma�i naarns C�ry S�a�r�z�p anone � <br />� EN� fZCTMS q i 3�(O ��� �� � <br />� Stato Ucense Number ConVact Pnce o} Work � <br />rnmm�rci t�l <br />Proposed Use of Builtl�ng <br />Square FooL�ge (II res�denbal new consVucUnn, remodel or adCihon) <br />Descnptian of Work lo Be Done. <br />I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />i BE IN RACEWAYS. MC OR AC CABLF . <br />CfTY OF EVERETT IOCAL SALES TA7( COOE IS 3f 05 <br />Contaet Person (Plan Review) <br />, 1 hemby ccrbly thef I have read and exannned fhis apphraGnn anA knnw the sanrn io Ae Iruc and <br />correcf. All provis�nns o! laws and ordrnances govemrnq this rype ol work wvll De cnmplefed <br />whefhe� spec�ed hrmrn nr noL The gn. nbn,y o! a permd does nof rcsume to give aufhnrrfy to <br />violafo or wncel fhep ruv�sions ol any othe� sfafe or lowl law reguPtmg construchon or �he <br />perlormance o/ consWGion Thal I am authonzed by fhe owner ol Uris proporry to peAorm fhe <br />work lor wh¢h applicaGon is made and 1 comply wRh Ne SYate Conlrac(ors Law 18.27 RCW and <br />296.700 WAC.A � <br />/� <br />� SignaNm I Date <br />L.__—. _. —_—_— ___ _ —__ � _.—._ ___ . _ <br />FEE � <br />I <br />I�J�.� � <br />L�30�-II�- <br />� <br />