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ELECI'RICAL PERMIT APPLICATION <br />Cii'r OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />PROJECT ADDRESS <br />�'_� <br />Owner <br />Tenant <br />i. <br />� '' ' � <br />Electncal Coniractor <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />IAatl Atldress <br />Mail Address <br />i„�'� �� �f'�I <br />Mad Address <br />I�• I' _ i i � i � - <br />State License Number <br />Propose� Use ol Bwlding <br />� , � ,� i �: �, ��, <br />Uly <br />Gty <br />Square Footage (11 residenUal new construction, remodel or adddion) <br />Descnption ol Work to Be Done�. �� � V �� l � i����� -�L.- <br />I <br />NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RFlCEWP.YS. MC OR AC CABLE . <br />' <br />Cily <br />; ,(� � �� i,.' <br />, � � „ <br />Stale./Zip Phone <br />Slate2p �h� <br />l��lll'��i'`�� �I:�-. li"' ��� <br />SlalelZip Phone <br />'l -7 <br />��� �� �.'i�1L� --� <br />Cor�tract Pnce of Work <br />�, .�, `� �'I �l l l <br />Conlact Peison (Plan Review) <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />1 hereby ceRdy fhaf I have iend anJ eaanunr,d tbis applicnhon and know the same fo be fn�e nnd <br />conecf All p�ovis�ons ol laws and ordmances govemmg fhis type ol work wdl br, comp�efed <br />�vheflier specibed he�em or no� The granhng o! e peinut dces nof presurne fo grvo aulhonty to <br />violafe a cancel !he prov�s�ons ol any ofher sf�fe oi l�:al lnw �egu/ahng corrstruchon or the <br />perlormance o! construclion Thut I am authonzed b y Ihr. owner o/ fh�s propeRy to perform fhe <br />work lor whir,h apphc�fion is made and 1 comply wdh the Sf�te Confrnclnrs Lnw 18 27 RCW and <br />29ti 200 WAC <br />i <br />'' � �� � �.� i, � l�) ��I � � - <br />; ;; . <br />FFE <br />� � �')�'. <br />j J <br />C.. I �-i � � J I <br />