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ELECTRICAL PERMIT APPLICATIQN <br />CITY AF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETl', WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTFD FROM 8 AM TO 4 PM <br />/ <br />I�G`1 l�'lc �nvc��� �I�E Lv-�er�', G+�R °l�l,���i <br />PROJECTADDRESS <br />Owner <br />Tenant <br />Electrical Conlraclor <br />State License Number <br />I�r � IUCNIIA� <br />Proposed Use of Building <br />��C+n� �' <br />Mail Address <br />Mail Addresa <br />Mail Address <br />Square Footage Qf residential new conslruction, remodel or addition) <br />City <br />City <br />City <br />Descnption of N'xk to Be Done: I<C('LA(.G LLLCCi!' lCR ! �!ati'%l <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OF: AC CABLE . <br />i � au —�3 <br />C-13�1��3z <br />Sta��elZip Phone <br />StatelZip Phone <br />Stale2ip Phone <br />� �, c��p,00 <br />CorAract Pnce of Work <br />i <br />Jo����eN v�:�.�Er� <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCA� SALES TAX CODE IS 3105 <br />I hereby ceRi(y that I have read and examined this auplicafion and know the same lo be trae and <br />cormct. All provisions ol laws and ordinances goveming this type of work �vill be completed <br />�vhether specilied herein or not The granfing oI a permrt does not resume to give authonty to <br />violate orcancel the provlsions of any other state orlocal law 2guPting consW �toon �`t� �' e <br />perfomiance o/construction. That I am auth�nzed by the owner ol this properiy pe <br />work lor which applicahon is made and 1 compty �wth the J'tafe Contracrors Law 18.27 RCW and <br />296.200 WAC. , <br />•�� <br />FEE <br />__� � 0� <br />� l�01-(3�� <br />