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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 3 _�� —/3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �/3a 3'-063 <br /> � �� �� �� � <br /> � <br /> I PROJECTADDRESS <br /> '• '�-l.: ',• ,� d �C ' ��c ��� �� <br /> Owner MeilAddress Ciry Stele/Lip Phone <br /> � �� , � � .�� �,�;{� ��s�- s� �-3����� <br /> _�.� �_ <-�,�'r � ���,,, , � � <<�� �� � , _ - <br /> Tenant Mail Address City Slate2�p Phone <br /> � ' � % � � � �C %'�'c' 7�'���5�/Cr' t�-�.c '�- '-�;� l_✓J1`S�c'� <br /> ,?_� �� ;':� 7i:'i� �� , ,c �'� %C. �� - <br /> EledricalConUactor MailAddress Crty Stete2ip � Phone <br /> �l[^ `�C�'-/Gf <br /> /l / / � � � . '' �� � � ,�� _ Y� Cc(� i� _ ���. <br /> Slate License Number Contract Price of Work <br /> � I' / ��" - , <br /> � . :, . ; t T"'/�.��"� �v Conlact Person (Plan Review) <br /> Pwpo ed Use ol Building � <br /> U_� ? ,;�,� <br /> Square Poo�age(If residenlial new consl iction,remodel or adddion) <br /> / ' � /r CC �'� �' i l' i'�[(i1�l - <br /> Description of Work lo Be Done: c� c � c 2__T_ _� !_��/� , <br /> , �� � � / i� �<, < A � L. . `���' . :t.i�.C��� �/ F�r nr.S�L' A�lr <br /> --'_'"—�_—`__— � <br /> � � � � � � ..{� ' <br /> � �..� -�� `n il – <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> HE IN RACEWAYS, MC OR AC CABLE . --- �C��� <br /> i 7 � <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> �� 1 herrby�:ertdy that I hnv�read and r,mnined(his applicafion and Nnow fhe sanro fo ba hue�nd � ����. ��� <br /> I comrr.L All prcrvisions o//mvs nnd or.lrnan::es governrng Ihis typo ol work�vill be completed � <br /> whcfhc�specilicd he�ein or noL Tho y�m;ting ol a parnnf does nof presurno fo give nufhonty fo <br /> iviola(e or cancel the/vovisions olnny olhe�sta(e or local lnw rt!gulafing conSWclion o�fho <br /> perlonnance ol consfruction. Thnf 1 nm aufhonzed by the awner ol thrs pmperty fo perform the <br /> �rnrk lor which npplica(ion is niade and I comply with fhc Stafo Confroclors Lnw 18.27 RCW and <br /> 296.200 WAC. <br /> � i ,� <br /> ' ' ��--( � �� �� � ` <br /> —' Signeture <br /> d OB18 <br />