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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 />�� � ( � �(� ���c?-''� %�/ vv <br />PROJECT ADDRESS <br />/,� t �� / � ,�r� <br />�C �%�.�z �� � f cz -'�sc��1 S ��':'�` (�,L�.v�,•y���sL/?�/� <br />Owner Mail Address C <br />Tenant <br />Electrical Cont�actor <br />State License Number <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />City <br />City <br />Square Footage (If residential new construction, remodel or addition) <br />' � i , / C <br />Description of Work to Be Done: �/ '� t�� <br />�i , ; �n�s �_ .� � , / /,� / � c . O � 1 � 7� . �!� � _ 1/� /� / ��" < <� <br />State/Zip <br />State/Zip <br />State/Zip <br />���,C� -�'�����6� <br />-� � <br />Phone <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Phone <br />Phone <br />'� � ��l - <br />���� • . -, <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE . ,� r` <br />� �� <br />� ' <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined fhis application and know the same to be true and ���� ,` � <br />correct. All provisions of laws and ordinances governin� this type of work will be completed �-� I, <br />whether speafied herein or not. The granting of a pe�m�t does notp resume to give authority to r V <br />violate orcancel tl�e provisions ofany otherstate orlocallaw regulating construction orthe <br />performance of construction. That I am authonzed by fhe owner of this property to perform the <br />work for which application is made and I comply wifh the Stafe Contractors Law 18.27 RCW and <br />296.200 WAC. <br />,-, � ; �� _ <br />gnature - Date <br />