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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � ��r�`�I I�r t>'•1[� 1 L�� � <br /> PROJECT ADDRE5.5 <br /> �1"� `��� til�� �r��� �1 (� , I;e��� ��)A 9� �'(, �f <br /> Owner � MailAddresc Ciry StatelZip �yM �Phone <br /> —7---_ �— � . ` �� ��� � c�n�r�a� �-v� � a t Cn,�3-�.�� <br /> Tenanl I � Mail Address City StatelZip �!!�_ Phone <br /> tJJ <br /> �' �� � i �+ I�����ii r - �� �� ' � y3r� � = �0 <br /> Elettrical COntradOr Mail Address C+tyf SlalelZip Phone <br /> �n <br /> r-_� — �Nc,Rr__;A �;3�i �tl y- ►E� � .��niy ��.c� <br /> Stale License Number Conlract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Foatage pf residential new const�ic[ion, remodel or addition) . <br /> ��l3�lr��j <br /> Descriplion of Work to Be Done: ��'n n�� 1 `��IQ i�l � � �Q�,��� Q �� 1 ��1r �������r J y� <br /> � <br /> �1 ;� S vC t��„/ <br /> —� - � ,�, <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certdy that 1 havo read and examined Ihis application and know the same to be true and 1 � <br /> con�ecL All provisons ol laws and ordinances yoveming this type ol wo�k will be completed <br /> whefher specd�ed herein or noL The gran6ng ol a pemul does not presume to give authorrty to , i � <br /> violafe or cancel the provisions o/any o(her state or local law regu�atmg construction or the ��'LO S � I, <br /> performance o/consriucfion. Tliaf 1 am authonzed by the owner of this property to perform ihe <br /> work lnr whiclr application is made and 1 comply wifh fhe Stafe Contradors Law 18.27 RCW end <br /> 296.200 LYAC. <br /> /�,��� /�u ���r�� s - a, - i a <br /> Signature Date � <br />