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• <br />• <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF �\/ERETT' F'�RMIT SERVIC�� <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 />j � � <br />C; � r_: - L�S t/�( C� � l) . %��L! �'.L: i% C�� A`� r�:3C'� L( <br />PROJECT ADDRESS <br />Owner <br />PJlail Address <br />City <br />State/Zip <br />Phone <br />� �"( ��-�� �7 {PG'"s��� a ( �lC � (� (-�;_� C 1�Y"r (—�=l t�l ��- � - <br />Tenant Mail Address City State/Zip Phone <br />;�/CC-1,%�-r� i=� i��%/=�lC i>�;'�%_; /� tG//1 vi`- i�l �.= jcv�f+� r✓' L�.'/-�. �r���l <br />Electrical Contractor Mail Address City StateJZip Phone <br />C�'/ z �l �r�r -s �� <br />� �: `= t , <br />� <<c�'���� �- � �' �'/G� �� ;�`' �� �-�t, .. <br />State License Number Contract Price of Work <br />C,c:� �''t�t l'l/1 - <br />Proposed Use of Building Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition) <br />Description of Work to Be Done: :'�}� � �' � �, j L� ✓7 — ✓ �'`�� �� ��! L �C��/ �'-� y�Z✓ .S j <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />FEE <br />� � � G�CJ <br />1 hereby certify that 1 have read and examined this applicafion and know the same io be true and I �-� <br />correct. AlI provisions of laws and ordinances govemm� th�s type of work will be completed �. ! C��t -' ��� <br />whefher specified herein or not. The granting of a permit does not presume to give authonty to <br />violate or cancel the provisions of any other state or /oca/ law regulating construction or the <br />performance of construcfion. That 1 am authorized by the owner of fhis property to perform the <br />work for which applicatron is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />�; ��� ��� � � <br />ure " <br />