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-- -- — --- —� <br /> ELECTRICAL PER11111T APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �`U _�3 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> ��3a3-oai <br /> APPLICATIONS ARE ACCEPTED FROM 8 Ah9 TO 4 PM <br /> � �' �� �� jlic;��� �(i , '� _ <br /> PROJECT ACDRESS - � <br /> Owner Mail Address City StalelZip Phone <br /> �( ,�� ,-:� �_'� ; i � ':; : .-, . = <br /> Tenant� � 'Mail Address City State/Zip Phone <br /> ( <br /> . � � , -'/ , � � • ' ',j �'' � :� i��% �� � � <br /> �Electrical Contractor � Mail Address� � � � City State2ip Phone <br /> = r '� �, i: � ;- � ��� . �: i- �_. .-��:.��(� <br /> State Licen;e Number Contract Price of Work <br /> � <br /> I��' ; i . ��� � r � �.� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> , <br /> 1 , ._ <br /> Square Footage Qf residenlial new construction, remodel or addition) <br /> Descriplion of Work to Be Done: _ � ��� ' � �� ��� � � � �� `' ��� ���' � ' �''� <br /> � <br /> � 50 dwi`c es <br /> � <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> � I BE IN RACEWAYS, MC OR AC CABLE. j„f iL'J <br /> r/lJ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceAi(y lhat I have read and examined this app(ication and kno�v(he same to be tn�e and I` � ? U� r\� <br /> correcL All provisions af laws and ordinances govemmg fhis type of�vork will be complefed C `J <br /> whether speci(ed herein or not The gran6ng o/a pennrt does not presume to give authonty to <br /> violafe or cancel the provisions o(any other stafe orlocallaw regulating consWction or fhe <br /> perfomiance �/conslnichon. That 1 arn aufhonzed by the owner o(this property ta pedonn fhe <br /> work for�vhich applrca6on is made and 1 cornply wdh the State Contractors Law 18.27 RCW and <br /> 296200 WAC. <br /> � ... , ,� - . `� . r - <br /> � � <br /> SlgnaWre ' � Dato <br />