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;� <br /> f_ --- <br /> -- -- - <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETI', WA 98201 <br /> 425-257-8610 - FAX 425-257-8857 —www.everettwa.org � _ �� _ / 2 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C /Z� ' <br /> Q�O <br /> � � g �, ,� ,,�� , ,� � ,�, z i,� ��� �� � r <br /> PROJECTADDRESS <br /> /� ' � . <br /> /� �c,. / �� L' P ✓ Y i s' r� <br /> Owner <br /> Idail Addres City Slale2ip Phone <br /> Tenarl <br /> Mail Address City SlatelZip Phonz <br /> � / J ' � i <br /> /(/Ol �/Jrvn � /(��' .li/P[' �%/�l <br /> Electrical Contractor <br /> Mail Address City SlatelZip Pho�e <br /> State License Number CoMrect Price oi Work <br /> Proposed Use of Duilding Contacl Person (Plan Review) <br /> �Ln �� � <br /> Square Footage Qf residential new construclion, remodel or addition) <br /> Dr,scriplion of Work to Be Done: �� y� �LL �✓ /�v � � <br /> 1 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � � n [- <br /> !hereby ceriily fhat 1 have reaA and eaamined this applicafion and know(he same fo be true and C I �-l..J'1 -UJ� <br /> corcect. A/l provrsions olla�vs and ordinances yoermmg(his type o(�vork��✓ill 6e completed <br /> chetherspecilrod herein ornoG 7he gran6ng oI a permd does nof �resume fo give authonty to <br /> violafe or cancel thr,provisions ol any ofhersfate orlocal law regulafiny constn�c6on or the <br /> pedonnance o/consfruction. That 1 am au(honzed Gy Ihe o�ti�ner ol Ihis propeRy to pedorm!he <br /> �ti�ork for which applicafion is made and I comply nafh fhe Sfate Confractors Law 18.27 RCW and <br /> 296.200 INAC. <br /> ��i��--��� �%��J�� 9 <br /> Signaturc 7Date <br />