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ELECTRICAL PERMIT APPLICATION <br /> C17Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-88'10 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ., . . . � "�i. , _ .. �; -�i_ I?-- <br /> (' _ <br /> PROJECT ADDRESS <br /> ,._ li . • Il�.f,- � 1 -�._ � - . � .. .-:-_ ��.�C=_ � � . - ���:c ���,J . �[ �.- t- ' . <br /> 1� <br /> OWner MailAddress City SlatelZip Phone <br /> Tenanl MailAddress Ciry Stale/Zip Phone <br /> � � i ; , , .� i <br /> .� t� <br /> Eleclrical CoNtaclor Mail Address Cdy State/Zip Phone <br /> Slate License Number Conlract Price of Work <br /> Proposed Use o(Building Contac�Person (Plan RevievQ <br /> i <br /> Square Foolage Q(resideniial nev+conslruclion, remodel or addition) <br /> DescriplionofWorklo �eDone: I� � �'-�'��. tz�'��JL��� �'- <br /> I <br /> I <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO F[E � <br /> I BE IN RACEWAYS, MC OR AC CA6LE . r/�-�,' <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �/ <br /> I hereby certi(y th�t I have read and examined this��pplication mid Icnov+fhc same fo be tnie and - I <br /> cormct All provismns ollaws and ordinances govemmg fhis fype o/work ndll be completed �I Z � � _ U�1 <br /> „I�elher specified herein ornoL The gran(ing o/a pennd does no( resurne(o give aulhonty fo ,� <br /> violate orcencel lhe provisions o/any ofher sfate orlocal law reguPating cons6uchon orihe <br /> pe�fortnance o/constn�clion. That 1 am aufhonzed Gy the o�vnero/this rnpe�iy to peAomt the <br /> rrork/or which application is made and I compty�vith fhe Stale ConfracPrs Lmv 18,27 RCW and <br /> 29G.200 WAC. <br /> �� 1 '. ._ - -- - l � l�� i <br /> Signature Dalo <br /> I <br />