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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 96201 ,�j --I I —I 3 q <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org � / 303'-�� I <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ;-v �'.� I3�a<„lw�/ <br /> PROJECT AODRESS <br /> ���� 1� ' t� o`r //i,��t�cc� �oii �3`� %���tY u/�4 `J6'.��3 <br /> Owner MailAddress Ciry State/Zip Phone <br /> Tenent MailAddress Ciry StatelZip Phone <br /> %� ) _ <br /> �i"c-t�ilSiv / /�/rcf✓ c 1 c /�J� � %) /7�//.,yh.. 4/� 1�'�d3 �.�-c-a�:1.� <br /> [IeciricalContractor MailAddress City State/Zip Phone <br /> /'J='u /�v/= Tv 7 7 .�/� b s � � <br /> Slate License Number Conlract Price of Work <br /> ����� r f <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residenliat new construc�ion,remodel or addition) <br /> Descnption of Work lo Be Done: /Zc �a� f� / �'�-•�r� / c'� .�" /— j�rJ v 1,�� <br /> � � " �lzK �/�' /�ri., /r/ r-/-- J" /Zdl� ,�cJ/7i. � /> �/Y �rJi9 <br /> i� i��� �,�- r <br /> NOTE: WIRING IN NON-DWELLINGS IS kEQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �� �'d <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceRily ffi�3t 1 have read and examined this application and know(he samo to be fruo and <br />� correct. All prnvisions ol laws and ordinances 9ovemmg fhis typo o/work will Ge compieted �i /'7�� _ i-,/„�7 <br /> whefher specr0ed her�in ornot The granling o/a pennd does not presumo to give aufhonty to I �hy / <br />� violafe orcancel the Provisions o/mry o(herstafe orlocallawregulating cons(rucLon orfhe <br /> perlormance o/construclion. That 1 am aulhonzed by the ownerol fhrs properly fo perform the <br /> work Ior which applicafion is mado and 1 compty wifh tho S(ate Contractors Law 1827 RCW and <br /> 296.200 WAC. <br /> � .`Z-t. , �1ljz>t 3 / /- /..s' <br /> Signeture Data <br />