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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 425-257-6857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> -1 ` 1 Ll 13ev. (31 v � . <br /> PROJECT ADDRESS <br /> 1-�a�.�k���s 1�-�s 3�z Z s� � �� � m�.�ys, . �, 9�zz� <br /> Owner Mail Address C�ry State2ip Phone <br /> �zs-Z�d -2y z 9 <br /> Tenant MailAEdiess Ciry Slale/Zip Phone <br /> n w�1 eit' <br /> EledriWlCOnVeGtot MailAderess Ciry StateZp Phone <br /> State License Number Conlract Pnce of Work <br /> SF� <br /> Proposed Use of Building � Conlad Person (Plan Review) <br /> Square Footage pf residenGal new construc6on,remotlel or addition) <br /> Descnption of Work to Be Gone. IL v� ��, e.���`� �` _ <br /> NOTE: WIRING IN NON-�WELLINGS IS REDUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �O� <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> I hereby cr,rti(y fhat 1 have read and oxamined this applicalion and know the same(o Ge frue and �I 2 0 2 � O�� <br /> correcL All p/ovisons o/laws and ordinances govemmg fhis type o!work�ti�ill bc comple(ed � J <br /> whefher spec�fied herem or not Tbe granting o/a permrt dces nof Prr,sume to grve authonty to <br /> violate or cancel the proWsions o/any other sfale or local law«gaahng cunstruc�ien or fhe <br /> peAormance ol consliuctron. That 1 am aufhonzed by Ihe owner ol fhis prapeRy ro pedam the <br /> work lor which application is made and 1 mply wifh the State Contraclors La�v 1827 RCW and <br /> 296.700 WAG. <br /> 3 /z � <br /> Si nalu • "Dale <br />