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( ' <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <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 /> �0� EaS� �si r�a � �' �✓� �� `�$o�� <br /> PROJECTAD�RESS <br /> JS u P r���5�`D��•Q �c�ar�s �as �vss_o� <br /> Ownet MeilAddreee Clly Stete2lp Phone <br /> �I �'� <br /> Tenent Meil Addreet City Stete2lp Phone <br /> r�-�,�a' Po � �S3�1 ��—ld.2� 9�'c�C �a�'as�a�s <br /> Eledtical Contractor Meil Addrees City State2lp Phone <br /> �/�U�e CL ��1 O U � _ �00�� <br /> Slate License Number ConUect Price ol Work <br /> l '�A � �1� — <br /> Proposed Use of Bullding Contect Pereon (Plen Review) <br /> � � <br /> Squerc Footege(If realdential new consiruction, remodel or additlon) <br /> Description of Wark lo Be Done: � � �O � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE � <br /> BE IN RACEWAYS, MC OR AC CABLE. G fl <br /> �_J V <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br /> 1 heraby certily fhaf 1 have reed end examined fhis application end know the same to bn tn�e and �I�O� � O C� <br /> correc(. All provlsions o/lews end ordinances goveming fhis type ol work will be complefed J <br /> whefherspecrfied hereln ornof. The grenting ol e perm�l does not presume to give authority to <br /> violefe orcancel the provfsions o/any othorsfate orlocallew raguleting construcfion or(he <br /> peAormance olconstrucfion. Thaf 1 am authorized by fhe owner ol fhf.�p roperty fo peAorm the <br /> work lor whfch appdcation!s made and 1 comply with fhe Stafe Contrac(ors Law 1827 RCW end <br /> 296.20 AC. <br /> � �l� �� � ia �� <br /> Signatura ale <br />