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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9R201 <br /> 425-257-8810 - FAX 425-257-8857 —www evereltwa.org <br /> APPIICqTIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � <br /> / , <br /> , �:(�l �� l �7 l�� �✓C";f - <br /> PROJECT ADDRESS <br /> ( vYrt 'Y� >7r�7f <br /> Ownef Mail Address City StatelZip Phone <br /> � <br /> Tenanl Mail Acdress City State/Zip Phone <br /> � ,i ' c�-`i s 1,, � - �„ �f�yY2 y1-�-76�--� <br /> i , .f, '�� f-1 , �i,� - i �� ZS �f,1/ �1��1wcr.� � /f � � ������Z <br /> GlectiicalCoNractor MailAddress City StatelZip Phone <br /> � �� 1�� � I �t� ������ ����0.� L <br /> State license Number Contract Price o(Work <br /> IProposed Use of 8uilding CoMact Person (Plan Review) <br /> ! Square Footage(If residential new conslruction, remodel or addition) <br /> 1� �/� �y— �J� <br /> Deceriplion af Work to Be Done: Y i !�' TYY7'' � V�� I� (��SL'- — <br /> i <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> I BE IN RACEWAYS, MC OR AC CABLE. <br /> ; 75°� <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � 1 hemby.:eriily thaf I hove read anAexamined Ihis application and Hnu�v the same Io be In�e aed <br /> conec(. All provisions o/laws and ordinances govemurg Ihis t}�pe ol worh wiil be completed � <br /> �rRelher specr/icd herein or noL The qranting o/a penrid does not prrsume fo give aufhonfy fo ,� r�>_/�-� <br /> � �Iviolafe or cancel the provisions o(any olher sfate or locallaw mpuldtiog construc6on orthe � � i �, � <br /> . pr.Aonnance o/consliuction. That 1 am authonzed Gy!!ie ownoro(this propeRy to pedonn Ihe <br /> � ::ork(or which applicafion is made and I compty with the Sfofe Contr�c(ors Law 1827 RC W 2•id <br /> ', 296,200 WAC. <br /> � -� =� �� ' -- � �'� 2�'� � - <br /> - Signalure Daie <br /> I __J <br />