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i <br />ELECTRICAL PERMIT APPLICATION <br />CI1'Y OF �VERETT' I'�RMIT SERVIC�S <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 />� j1 4;" � 1 n i� ' <br />�4- � � �t� » � ' t . , <br />PROJECT ADDRESS <br />��,�.. <br />.,� +�� �°�e'' r �`�s `�.� < : �:�" �,� �,� u�*: � G <br />Owner Jlail Address <br />Tenant <br />Electrical Contractor <br />(.� � �>�,����� � -: <br />State License Number <br />Mail Address <br />Mail Address <br />���:� ti c�� � <br />City <br />City <br />City <br />�'"� � <br />S t I4.G �', � 'y' ,��',`1 i'- '• �7 .' f .,• <br />Proposed Use o���Building ,� <br />,� ,� <br />�� ,�'a� <br />Square F age (If �esidential new construction, remodel or addition) <br />CP"'� ' <br />.� 4 �� �; �. <br />�� ��� ������ � <br />State/Zip <br />State/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />! I � I � <br />Description of Work to Be Done: ,� � � � .. 4' �` � � 4-• � ,,,� '`` ti�� .�-�^` �' <br />: �� � <br />� Q. � �,� �j f-�.J ✓) c" i % ' . � " rr���, s:� `"� � ` �,° _ . <br />�_. <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 />I hereby certify fhat I have read and examined this app/icaiion and know the same fo be true and <br />correct. A!I provisions of laws and ordinances governing this type of work wi/l be completed <br />whether specified herein or not. The granting of a permit does not presume to give autl�onty to <br />violate or cance! the provisions of any other state or local law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.20QAWAC. <br />+ P! <br />F � ,. <br />i <br />� ' : .� � � ��� �< �,r.. � C .� =� ` <br />Signature Date <br />. �; <br />FEE <br />�sr-,�J <br />�� <br />Phone <br />Phone <br />Phone <br />�cz�� _ ���I <br />� <br />� <br />