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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 � -i a-o3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �'� � a�07� <br /> z�w �'-<z� 7f �° <br /> PROJECT ADDRESS <br /> , , � o /-�e«.�� � �-��r c,�� y���/ <br /> L-�,r�� �.�� �w.-, S�s . > z <br /> OWner MailAddress City °tale/Zip Phone <br /> Tenan� MailAddress Ciry Slate2ip Phone <br /> Y4�S {� <br /> L! �Clf"C(1���� 7��1 �z7 � � �vC C r,' ��7ii(,� Wvr .�t�SZ UJC�S'�rU� <br /> Ele lricolCoNractor MailAddress Ciry State2ip Phone <br /> op <br /> �> >P -� l ��S�1�1� �o`,`� <br /> Stat icense Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Foota�e Qf residen�ial new construction,remodel or addition) � <br /> Description o(Work to Be Done: ��'��� � � ` � � �c. � �"'��' � <br /> NOTE: WIRING IN NON-DWGLLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � � SD <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily ffrat 1 have mad and examined this appficafion and know fhe samo fo be fn�e and � l 7�� , O�, / <br /> correcL A/l provisions o(laws and ordinances govemmg tliis type o/�vodc�vdl be cempleted i � '-t <br /> �vhether speci6ed herein or noC The�ranting ol n pennd does not presunte to give authonty to � <br /> viola(e orcancel fhe provi:ions ol any ofhersfafo orlocal/aw regulating construcfion orfhe <br /> pedommnce olconstruchon. That 1 am aufhonzed by the oivnerolfhis property fo perfomi the <br /> wo�k lorwhich application is made and I r,omply wifh the Sfa(e Confracturs Law 18.27 RCW and <br /> 296.200 WAC-�� <br /> /: i•�i . � <br /> I� .� ���// Z-/� - i <br /> , / �Z� r���C �/ " �/ Dale � � <br /> SignaNre / <br />