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Et�ECTRICAL 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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM �O 4 PM <br /> � � Z� P 5� �rW� <br /> PROJECTADDRESS <br /> �'��c��- ���,�2— �l 'zl C�o�F. Q.1��k.a��� �� <br /> q6�o1 4���S�l-/a 2 <br /> OWner MailAddress Ciry State2ip Phone <br /> Tenant � MailAddress City Slate/Zip Phone <br /> ��,�s�, ��p�-t���� c.� �� c����to ���-� ��a ��oc� qa�-35-a3�1 <br /> Eleclrical Conirac�or Mail Address C�ty State�Zip Phone <br /> 'J�R'�SS � G �� rJ 7' �Y -- CoNract Price of Work <br /> S ate License Number ' <br /> ��k'�`'`��a�� ' j G� � Contact Person (Plan Review) <br /> Proposed Use of Building <br /> Square Footage Qf residen�ial new construction, remodei or addition) <br /> Descriplion of Work lo Be Done: �+��,I��l 'q(t)i� �' Q ��p' ' �� 1 GC"��(L ``'�Q��"'`6 `U <br /> I <br /> NOTE: WIRING IN NON�DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEV�iAYS, h1C OR AC CABLF. � ��Q <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y that 1 have read and examined fhis applicafion and know the some to be hue and ZGy <br /> cor.ect. All piovisions o/la�vs and ordmances goveming fhis type ol�vork will be completed � � 2-� — �`� I <br /> �vhelher speci6ed herein or noL The granting o/a pemut does not irsume to give authonty to <br /> viola(e orcancel the provisions ol m./otherstate orlocal law reguPting consWcfion or the <br /> poifonnance oI constniclwn. That 1 am authonzed 6y the o�vner of Ihis propeAy fo pedorm the <br /> r✓ork lor�vhich applicafion is madn and 1 comply with the Stnfe Contractors La�v 18.27 RC W�nd <br /> 296200 WAC. <br /> �o-�-ra� <br /> �i nature Oate <br />