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ELECTRICAL PERMIT APPLICAT�ON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT. �NA 98201 <br /> 425-257-8810 - FAX 425-257-8857- www•everettwa.org <br /> AwPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �_a �3 <br /> �� 3o��z <br /> / > > rt',� � t .�r �c '� �,,� �t' J f;T u I <br /> 1�LL l�.•'t ' " L <br /> PROJECT ADfiRESS <br /> '- / _ 1� /t `$ �Lo/ '-!l�S-!L i l t- <br /> �l`� i.�-: ,l�.i ! lytc• /LI.� Ckc•r /iJl �Jr�: V� � <br /> Ownef Mail Address City State/Zip Phone <br /> �� �, � 6.� , r ,�, �,�, <<<., �� � t�����*t- w �- �� � r� i yy5�yv s>> �- <br /> J � �t <br /> TenBnt Mail Address City State2ip Phone <br /> ✓l� � C !� <br /> Cit StatelZip Phone <br /> Elecincal Conlredor Mail Address Y <br /> ��-',�nC� . O CJ <br /> Stale License Number <br /> Conlrad Priu:�f Work <br /> �r� <br /> Proposed Use o(Bwlding Contact Person (Plan Revie�:�) <br /> Square Footage pf residential new wnsWction,remodel or addition) <br /> /,,v e, ,' '— "1_ , r ., e• !" it-v ..J � �- . �. � C'-'" <br /> Description of Work to Be Done: , <br /> � /�- c 'fJ t.. � i-. r � '.�, � . c. <br /> .a c � P ..J � C ��' [ �t � � <br /> / / �sZ �fa �, flS 'c. � - s.,/47l '`h <br /> �. `� .�y`, ��f f i• c � f�N"{' � [ r '�'. r � <br /> a� ,�, .; � , s � ., , ` _ <br /> N07E: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ���� <br /> I �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby r.ertily that 1 have read and examined this applicafion and know fhe same to be fn.•e and `.,^� <br /> co�recL All p!nvisrons oflaws anA ortlinances qoveming fhis type ol work will be completetl �l 30 l ' O�J <br /> whefber speci(ed herein or noL The yianfing ol e�md does nof�resume lo give aufhonty to L <br /> violate or cancel fhe pmvisions o(any otlier sfate local law regulafing consWction or Ihe <br /> pedomtance d stmclirn �T7ia1 1'am authnnzed f y the owner ol this`noperty to pedorm fbe <br /> work(oi tvbich$�licatiori,i�rnade ar�d 1 complY wi �the State Contracfors Law 18.27 RCV✓and <br /> 296.20 WAC. �� <br /> � -= �� �, _ � � � 3 � _ <br /> Signature Date <br /> � <br />