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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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �;-��� � ��-'a�tLvo'1t /�li'� . �:v�v�t{ . l,i,��� '�ow � t,✓/� <br /> PROJECT ADDRESS <br /> �;��C�e,�-r . 9k"�Y_ <br /> �2��c1 /�/l � <br /> �-��a���ua�, X�, c�4.z � Lal�� �v'asl�;,,�,G� y,�-6_�-�z� • <br /> Owner � Mail AAdmss ity StatelLp Phone <br /> Tenant Mail Addmss Cily S�alelZip Phorm <br /> '��nll1 C' y — <br /> Electncai Contrador Mail Address Ciry StalelZip Phone <br /> State License Number Contract Pnce ol Work <br /> '%iJ l7 <br /> I � <br /> Proposed Use of Bwlding Contact Person (Plan Review) <br /> Square Footape Qf residentia�new consWction,remodel or addition) <br /> � � �� <br /> Descnption ol Work to Be Done: �c �D� �' C��� n � S"t,tii+ � l� ��`"? � �' '-�� <br /> J(,n <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �j CU <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�105 <br /> I herehy certily that 1 have read and examined fhis applica6on and know(he same(o be true and <br /> conect All provisrons of!aws and ordinances,qovemmg this type o!work will be completed � I�I ' — � I � <br /> whc�lrer specilied herem or not. The granfing oI a permrt does nof presume fo give aidhonty to <br /> viola(e or cancel tAe provisions o!any other s(afe or local law regulahng constniction or the <br /> perfonnance o/construc(ion. That I am authorized by fhe owner of fhis property to perform fhe <br /> �vork/or which application is made and 1 compty with the Stale Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �� ��,���«�,t ti. �j— cz - Z �l 2 <br /> Signalu Uate <br />