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ELECTRICAL PEf�MIT APPLICATION <br />CI7Y OF EVIERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA °8201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org <br />APPLICPTIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />_ � <br />� � [� � �t�' � il1 ��S <br />PROJECT ADDRESS <br />�j� , <br />�.� � � 1,�,�� .,�� ����'IL� ��l��I��TT ��i1��'C( "`•''� <br />� �' >l � �" � <br />O�mer Mail Address Gly Slate2ip Phone <br />�t2�-- ��"3 � � � <br />Tenant <br />Electrical Conlrector <br />Atail AdAress <br />1�1N\�i)Cvt rY ;� �� , <br />Stafe License Numher <br />Proposed Use of Building <br />Square Footage Qf residential r.ew conslruction, �emodel or addition) <br />Description of Work to Be Done: <br />t�:��� ; <br />NOTE� WIRING IN NON-DV1�'ELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />mad <br />/ <br />� <br />and 1 <br />Cily <br />City <br />SlatelZiF Phore <br />L1Z5-�3 l-"1�20 <br />�r!> P �mr,hG �l�U��; <br />Slate2ip Phone <br />�% I C' �� � C�� <br />Coniract Price of Wcrk <br />C-Xan - n <br />Contact Pe' n (Plan Review) <br />Ihis applicafion and know lbe same fo be truo and <br />governing this type ol u�ark wi116o cumplefed <br />�/a pemut does nof prosumo to give aufhonty to <br />3fo or/ocal lae�regulafing consWdion orfhe <br />ized by fho owner ol Ihis property fo peAorm fhe <br />ly �vdh the Stafe Confractors La�v 1t3.27 RCW and <br />(ll��l��- _ <br />FEE <br />Y—�Z����� <br />