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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 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � g r� <br /> C 130 3-O '��' <br /> �s18 <br /> � -- � v��� r� � ,/� <br /> PROJECT ADDRESS � <br /> �' <br /> �� �� 1 I l�,'C�'� ��I^`� � -2�!2 �-}c7'��"�" �� ��'`�''--Q� `f�f <br /> Owner Mail Address City State/Zip Phone <br /> Tenanl MailAddress City Slate/Zip Phone <br /> 6 (��� C� �VE2.�I� y"� �' <br /> l��ss,� ���c,��c�� � P � y s� <br /> EleCtriCal ContraCb� Mail Address Cdy State2ip Phone <br /> � � r C�o a" <br /> Stale License Number Contracl Price of Work <br /> ���� �� <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> �L�� <br /> Square Foolage(If residential new construction, remodel or addition) <br /> Description of Work lo Be Done: <br /> �s�, �� �C��m� ���� R3�� <br /> � ���V I �� �.a� f�l'lc�(.�! L� �i�(�'( L,� �JU 7 �, . _ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �� S � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fh<�t I have read and examined this applicafion and know the samo fo be tnio and � (Z 2 /'� J/ <br /> correcL All provisions o/la�vs and ordinances govenring lhis type ol�vork will be comploted -� I ,J Q J— v y0 <br /> �vhether specdied hsrein ornot The granfing ol a permd does not resume to give authonty to <br /> violafo orcancel fhe p�nvisions cl any othersfate orlocol law reguPting construction orthe <br /> perfonnance o(conshuction. That 1 am aufhoiized by the ownero/fhisp roperty to pedortn Ihe <br /> work lorwhich ar�(ca(ion i made and 1 cornpty wifh Ihe Slafe Confrac(ors Law 18.27 RCW and <br /> 296.200 WAC. / <br /> � ��� / 3 <br /> Sign rc / Date <br />