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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � —�7�'� 3 <br /> 425-257-8810 - �AX 425-257-8857—www.everettwa.org ����`� �6 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��lZ� �a��v f�� �i�.��°�� /,� <br /> PROJECTADDRESS � <br /> Nzs-Z <br /> ��t l VA�1 LEu��1 1�-12� Co�`I �4UE Tv-�c�' GJk 98Zo ( Z�7 <br /> Owner MeilAddress City State2ip Phone <br /> Tenanl Mail Address Ci!q Slale/Zip Phone <br /> Electrl�C�ractor MailAddress C�ty State2�p Phone <br /> State License Number Contracl Price ot Work �zS-, Zge <br /> ���r�.r, c� YA�I �a�nit,�.u�i,I� zh� <br /> Proposed Use of[3uilding Contact Person (Plan Reviewl <br /> Square Footage(Ii residenlial new construction,remodel or addition) <br /> i Descriplion of Work to�e Done: ��P��� °� ��G���� .�A.�e l <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B[ IN RACEWAYS, MC OR AC CABLE. � � � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily Ihaf I have rtad and examined(his applicafion and know fhe same to be(n�o and <br /> conccf. All piov�sions ol laws and ordinances goveming this type o(work�vill be completed � � � �� <br /> r+helher s ecil�ed herein or not The ranting ol a emut does nuf resume to ivc aufhonty to <br /> violate or cancel fhe provisions o!any ofher stafe or local Inw mguPting constr 9chon or the � ' � <br /> pe�lomiance o/conswcfion. Thaf I am authonzed 6y fhe owner ol(his property to perfortn the <br /> �•.ork/or which application is mado and 1 comply wrth the Stale Contractors La�v 1827 RC W and <br /> 296200 WAC_i� <br /> /�/ /�`�`�"----- � �Z � �3 <br /> � Date <br /> V. -- Sianature--��'– / <br /> � <br /> � - — — - -- --- <br />