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ELECTRICAL PERMIT APPLICAT�aN <br /> CITY O� EV�RETT PERMlT SERVIC�S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - �AX 425-257-8857—www_everettwa.org <br /> APPLICAT30NS AR�ACCEPT�D FROM 8 AM TO 4 PM <br /> Dn��f � S� �r�� e �Id U�� �� <br /> PROJECT ADbRESS <br /> (�n�� �1���� � ��� � g �� <br /> Owtter Mail ress City StateR3D Phone <br /> Y`�' <br /> Te►l8n MaN Address City State2ip Phone <br /> � 5 UY� � �i � f �il�� 1,�Gf �022 <br /> Elsctrical Corrtractor Mai!Address City State2ip Phone <br /> r� � ��' �o�, DD _ ___ <br /> ate Lieense Number Contract Price of Woctc <br /> , v <br /> ropased Use f uilding.=� Con ct e�'son (Plan Review) <br /> . � ' O� � <br /> Square ootage(If resideRtial new constructian,remodel or addi�on) <br /> Descriptian of Work to Be Done: �l -{� �` '� �� �� �L� <br /> N07�: WIRING IN NON-DWE�.LINGS IS REQUIRED TO FEE <br /> BE IN RACElNAYS, MC OR AC CABL�. <br /> CITY 4F�VERETT LOCAI.SAL�S TAX CODE!3 3�0.5 <br /> I her�by cerdfy that I h�ve r�ad an�examined this ap�l�cation and know the sarr�ta be trr�e and <br /> corr�cf. All provisiarts ollews end ordinances govemrng this type af work wlll be campleted <br /> wheHter specfied i►erern or not The g►anting of a perm�t does not prssum9 to gfve authority to <br /> violate or cancef the provisiars of any other state oi loca!!aw r�gulaffng consfructron ar fhe <br /> performance of con�st�uch'on, Thal 1 am authorized by lhe oWner of thls prnperty fo pelfomt fhe <br /> w�ark for whiCh eppliea�ori iS m8de and 1 eomply wiftr the Stafe Cor►tracfors La►+r 9827 RCW and <br /> 296_20b WAC. <br /> l l �L I'� �c�.��—�c l <br /> Signacure Date <br />