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0'S;2i/�012 noN 16:2t Y;._\' <br />�001/001 <br />5-251 <br />EL�CTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-88i0 - FAX425-257-8857—www.everelhva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�11�25 �ovex st-. <br />PROJECT ADDRESS <br />T�nant <br />ElocMcal Contraclur <br />me�.ia�E31�s�� <br />Stalo licensc Numbcr <br />F'roposod Use of Oui�ding <br />1,1ai1 ACdre;s <br />htaJ Aderess <br />� <br />Squaro Footage (If rosidonUal new eonstruction, remodel or atldilion) <br />DescripUon of Work lo Eic Uone: <br />Cl,y <br />Ci,y <br />SlatelZlp Phone <br />n uv� a$�1�u� <br />SlatdZip Pl,enc <br />�b25o <br />Con ract Price ol Work <br />ConWct Porson (Plan Review) <br />z.. <br />NOTF: WIRING IN NON-DWELLINGS IS RCQUIRED TO <br />�E IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETf LOCAL SALES TN( COOE IS 3105 <br />I heroby certify thaf I h�ve read and exemined lh/s applicalion and know (be same 10 be lrue and <br />caror.t. AIl provisions o/ faws anAo�dinances govemmg lhis fype ol tvork will 6a complefod <br />whether spocifiod herein or noL The granfiny o/ a pormrt does not presumo (o giva authority to <br />violato or cance7 fhe provisions ol any ofhor slafe or local law requla(ing consbuctron orlhe <br />paJom�ance of conslructron. Thaf ! am aufhorized 6y fhe owne� o!lbis proporty to porform7ho <br />work la which applrcation is mad� and 1 comply w/!h !ho SI, le Conlrac(ors La�.v f8.27 RCW and <br />zsc zoo wnc. <br />�� 1.1�'� �/l�"�'I� 512 I I l Z- <br />FEE <br />�IaaS- l05 <br />