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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.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� D,; z- !ti �'�iln � i:t� v,'' � w�� ��i �/�,� �- <br />PROJECT ADDRESS <br />� �( Cj �o �/L <br />��! �[ �a 1' ! a ��-i c'J �U✓/N �i71%1 �%�l� <br />OWner MailAddress Cdy Slale2ip Phone <br />Ydr-ary <br />��� ll3C� G!/ 'l°�r�a� �r�,i' ��— GUC�il'� L::�,Q—�C�c�/ ?�AJ' <br />1��.':- /%?:,.�a� � <br />Tenanl Mail Address City Stale2ip Phone <br />W I � <br />fleclrica� CoNractor � Mail <br />State License Number <br />Propos d se of E3uilding <br />Square Footage (If residenlial new consiruction, remodel or addition) <br />Description of Work lo Be Done: � <br />Ciry <br />C/✓G✓i�J' <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hemby ceRi(y fhat I have road and examined this applic <br />correcL All pruvisions ef la�vs and ordmances govemmg <br />e-hether speci�ed he�ein ornoL The gronting ol a pemuf <br />violafeorcancel(he provisianso(anyotherslafeorloca� <br />pe�fomiance ol conslj�c6on. That 1 arn a�dhorized by th� <br />r�o�k for �vhich app gation is �nade and 1 cornply �vith the <br />296200 WAC. � / ,, <br />0 <br />� and kno�v fhe <br />fvpe of tvork �u <br />s not piesume <br />.� �/.f � � <br />State/Zip <br />ao� <br />Conlract Price o( Work <br />j.Gu�-e�� <br />Contact Person (Plan Review) <br />Phone <br />FEE <br />= to be (n�e and �� � � � U � � <br />complefed <br />re authonty to <br />tion or (he <br />o perfonn the <br />8.27 RCW and <br />