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� �✓t - /�Z / / -�,aZ <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 /> ; 7� � ( -� �b�, /�-�� <br /> PROJECT ADDRESS <br /> OWner MailAddress City Slate2ip Phone <br /> �✓r5�,��7�,..- '�5 �� 372 / Cv�O•� J�✓c L�ir7WiA y�zS9-z�s� <br /> (a�� Mail Address City State/Zip Phone <br /> , � P�� �(� � � �'.�Z� Z � Y�`' �,{ r�.� G--��,`w���f wri �zs Z '�J��asYb s— <br /> EI ctrical Contraclor � Mail Address City State/Zip Phone <br /> �4 (/ � Q � �l`� °� �(/ �UC� <br /> State Lic nse Number Contract Price of Work <br /> Proposed Use oi Building Contact Person (Plan Review) <br /> Square Footage Qf residential new conslruction,remodel or addition) <br /> Description of Work to Be Done: / � 5�z ����'«n� �7l �'�-U �h'`^< <P ��' ``��"`�t�— <br /> NOTE: WIRING!N NON-DWELLINGS IS REQUIR[D TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. / � �j� <br /> iQ �- <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y ccrti/y fh�t I have mad and exomined this application and know fha same to be frue and �f Z I ( —O�`� <br /> conecL All pra��is�ons o//ans and ordinances governmglhis fype o(work will be complefed J <br /> whefher specdied Ireiain or noL Tho granfmg o/a pennd does not resumo to give aulhority to <br /> violate orcancel fhe provisions o/any otherstate orlocallawreguPfing consWc(ion orthe <br /> pedormance ol cons6uclion. That I am authonzed Uy!he orrner ol fh�s property!o pe�form fhe <br /> worlt lor wh' 'appl�tion is made and 1 comply�vdh tlie Stafo Confractors Laiv 1827 RCW and <br /> 296.200� <br /> '%/ �Z � - �� � �� <br /> i � r" <br /> c.. <br /> � Signature Date <br />