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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 <br /> APPIICATIONS ARE ACCEPTED FROM e AM TO�1 PM <br /> 1�'13Z Pa��� �cldl wr�.y _ <br /> PROJECT ADDRESS <br /> 1Qde:r Cu-�-, ��0�2 �s+"19vc SE (3��f Wu 4fl�lZ� <br /> Owner MailAdEress Cify StatelZip Phwie <br /> Tenant Mail AOOress City SlatelZip Phone <br /> n� �:4�f ci1��,� _ <br /> Eleclrical COntra or Mail Addrcus Cdy Stale/Zip Phone <br /> State License Number Contract Price oi Woric <br /> SfR <br /> Proposed Use of Building Contact Person (Plan Review) <br /> I Z5� <br /> Square Footage (�f residenlial new construclioq remodel or addition) <br /> Description of Work to Be Done: !/✓ ��c /aT3 O S! /2 � Jj/iG y✓ �vo r+.w <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC UR AC CABLE. �� OO <br /> � <br /> CITY OF EVERE7T LOCAL SALES TAX CODE IS 1105 <br /> I he2by ceRily lhat I have 2ad and examined fhis appficafion and know Ihe same to be frue and � I� �_ � <br /> correct. All provisions ollaws and ordinances goveming fhrs fype ol worN will be completed � � <br /> whefher spea(ed herein or noL The granting ol a permrf does nof presume fo give authonty to <br /> violate or cancel fhe provisrons o/riny ofher stafe or local law regulatrng consfruc�ion or the <br /> peAormance o/conslruction. That 1 am aufhonzed by the owner o/�his property to peAorm the <br /> work Ior which application is made and I comply with the Sfate Contraclors Law 1B.27 RCW and <br /> 296.200 WAC. <br /> :� <br /> ��--���.� � �� %G�/ez. <br /> Signalure Date <br />