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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 �s—�3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �/3a 3--D3 Z <br /> ��� (�� ('t�rbl �'1 ��' LY�e���-+�" <br /> PROJECT ADDRESS <br /> L� i� ���.c1 f'�>rbin �r �verPti inl��. �r�a��l <br /> Owner MailAddress Qty Slate/Zip Phone <br /> � �`I� lY`� <br /> Tenanl Mail Address City Stata/Zip Phone <br /> �I;1��it1F{��1'ic. 2�iU51to���-1 Y�I C= ' !�Ic{�l;i i2— �I25 2I� ��i I <br /> Electrical Contraclor <br /> Mail Address City SlatelLip Phone <br /> ca�,��i � ��� �� � _ �� �.�c� � o <br /> State License Number Contract Price of Work <br /> s�� _ L �V <br /> , <br /> Proposed Use of Building Cont ct Per (P Review) <br /> Square Footage(If re5idenUal new wnslruclion,remodel or addition) <br /> DescriptionofWorktaBeDone: �V\� �`�1� Y K �1�� � ���1����1"� � <br /> ✓ <br /> f <br /> ' NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> �' BE IN RACEWAYS, MC OR AC CABLE. ��Q� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily Ihat 1 have read and examined tliis application and know fhe same to be frue and �I n�� O�� <br /> correct. All provisions o/laws and ordinances goveming this type ol vrork will be complefed � <br /> whefher speci(ed horein or nat. The granfing ol a permit does not presume to give nuthonty fo <br /> violate or cancel tho provisions otany olher sfate or local law rogulafing consWction or tho <br /> pedormance o/construcfion. That I t+m autbonzed by fbe owner o(fhis property lo pedorm the <br /> work/or which applicafion is made and I comply wifh Ihe Stafe Contrac(ors Law 18.27 RCW and <br /> 296200 WAC. <br /> �� / � � <br /> � �'%/; ;o�'�'�' 3/�/� 3 <br /> i <br /> .� Signaturb aio <br /> � <br /> I__._. _ _ .._.-_ __..___-_ ._ _.__-_-_�_____--.—___ <br />