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ELEGTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVIC�S g_a� _,,, <br /> 3200 CEDAR STREET, EVEP.ETT, WA 98201 <br /> 425-257-8810 - FAX 425 257-8857 —www.everethva.org � ��" ��� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� � � 7 �=��%�►-���---�'��' ��� _z�=�- �n <br /> PROJECTADDRESS <br /> � <br /> .l C � �� `��� <br /> ����.��� t� \'�- �Cv -� ' <br /> Owner <br /> IdailAddress Cdy StatelZ�p Phone <br /> I <br /> Tenanl <br /> Mail Address City StatelZip Phone <br /> '�-1:� --- <br /> Eleclrical Contractor <br /> Mail Address C�ty Slate/Z'p Phcne <br /> Sta�e License Number Contract Price o(Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Foolage (If residenlial new consUuclion,remodel or addition) <br /> Description of Work to Be Done: <br /> ����_ ��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO F�E <br /> I BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CUDE IS 9705 <br /> � C <br /> I hereoy cr.rtily that I have mad and exami ied fhis application and know Ihe s�me to be tn�e and � �; ' O , <br /> correct. All pr?visions ollav�s and ordinances yovemmg lhis type a/work will be completed '�- L- <br /> whr.(herspeci0ed herein or noL The granting ol3 pernut does notl�resome to gioe aulhonty to , <br /> violafe orcancel fhe provisions o(any ofhersfate orlocal la�v regu afing construcLon or tfre <br /> pe�lormance o/consfn�ction. That 1 am aufhorized by the o�roner o/th�s �roperfy to perlomi the <br /> �vork lor which aPplica6on is rnade and 1 comply wdh(he Stafe Con6ac�ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �, �, / / � ��j -- <br /> �i � ; � � '� "j � <br /> � � f, ( _` <br /> ��: ��- <br /> S�yn2ture Da�e <br />