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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 lo `�� _�.Z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �, �O `D7/ <br /> (J <br /> � l7 7i � �.`��'G\�1Q Q- 1;e-. <br /> PROJECT ADDRESS C��7 I) ' � Z <br /> ��l\ � ��bv�- oz ���� � ��. v�- � ?�vl 3�� <br /> Ownef PdailAddress City State/Zip Phone <br /> Tenant Mail Address City StatelZip Phone <br /> Z_Z(c��- �o(o <br /> L__l�_z__.��c� v��ir � `�Z�,•� I,v � u�D1 'S I,(/� `�U ,�i5' �3 <br /> EleciricalContractor MailP.ddress Gty State2ip Phone <br /> � l 5 C C' � 1 �� 17� — 2ov <br /> Slate License Number Conlract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construclion, remodel or addilion) <br /> , j <br /> � ' �►-� �n C � <br /> Descriplion of Work to Be Done: - � � � 1 <br /> !J C( C-�_ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAI'S, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> s � <br /> 1 hereby certi(y lhat 1 huve read and exarnined this applicafion and kno�v(he same to 6e frue and N I'21 - (�� (� <br /> conc cf. All pruvisions o/lan�s and ordmances govmnrnq l�us type o/work wdI Ue.completed �' <br /> whefher speafied herein or noL The granfing oI a pennd does not presume to give au�honty to <br /> violate orcancel the prawsions of any olhersta(e orlocallaw rogulating cons(niction or tho <br /> peifonnance o/constn�chon. Thaf I arn aulhorized by the o�merol fhis praperty to pedonn the <br /> �vork/or wluch applica6on isaR5�7e�j�Ycernp�Y wl0�fhe Sfafe Confrac(ors Law 18.27 RCW and <br /> 296.20 WAC. <br /> i (� I <br /> SignaWre D te <br />