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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 3 _� I `-I 3 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org C ' 3O 3 -0i / <br /> �O <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I <br /> � �,J � ��i(��� ���— <br /> ?ROJECT ADDRESS <br /> 1 �. � ^ �- � 't <br /> �c,_v I � 1T�✓S . <br /> Owner ` MailAddress �'rL� City State/Zip Phone <br /> �"w � �� ��5 " �� ��l <br /> , �- ' o �� �isl,e�' ��� �G�=✓ <br /> Tenant MailAddress Cdy State/Zip Phone <br /> _,_/ �(2S'- ��J <br /> f=(, � - hl /' 2 �;llil� ,4r���,t� l,�A ��ZZ3 3j33 <br /> , � o � ec�riC �� �IC ue <br /> EleclricalConiractor MailAddress Ciry � Slale2ip Phone <br /> � � / ' � �.�� <br /> �� � � � ��� ��� ��� Contract Prico of Work <br /> State Licensa Number <br /> -��-(�- �- i���✓ ��xc- <br /> � ' ' � U Contacl Person (Plan Review) <br /> Proposed Use of Building <br /> � <br /> _.(.�;\� <br /> Square Feo�age Qf residential new construclion,remodel or addition) <br /> Description oi Work lo Be Done: � '� ''�� � ��La���' S ����� -- <br /> � ,- 1" f?7 ��� <br /> � r <br /> j ._' „ <br /> � �}• l,— ��✓ J� l+ �. 5 �'�� 'N � — ,/.�,. ,,� /����r� <br /> 'r <br /> ' �IOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> ' BE IN RACEWAYS, MC OR AC CABLE. � /, Q cj O <br /> lJ U <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hem6y certily(liat 1 have read nnd examined Ihis application and know Oie same fo be true and � I ���` ��� <br /> conect. All prvvisrons of laws and onimances govemmg t4is typo ol�vork�vill be complefed <br /> �:1�etherspecJied herein ornoC The grnnhnr�o/a pennrt does notpmsurne fo give aufhonty to <br /> vialafe or cancel fho provisions of any olher sfafe orlocal law mgidafirrg constnicfion or fho <br /> peAomiance of construction. Tha(I am aufhonzed by fhe cwner ol(his property to peAonn the <br /> _ �vo�k/or�vhich app�ication�s mac�end 1 comply wifh Ihe State Contracfors Law 1827 RCW and <br /> 295.200 WAC. <br /> ��� � � �� <br /> � J�/��;� <br /> gnature Date <br /> I ---- --�----�--- — <br />