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' -- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERViCES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � �a5-12 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �'/Z� /� <br /> ���n �, ) -�i�t <br /> PROJECT ADDRESS <br /> l!/�f.'w�/ ��.0 S:x� /4iR 4�Fi-lr,�'rC fvk'� t.�.W 9br"csl <br /> Owner P.1ailAddress City Stafe/Zip Phone <br /> Tenanl MailAddress City StatelZip Phone <br /> i;�/�r,L-� ;�1=g�rn�' `—/7�7 �57�' qu= n.s �'JSIi a,.Q p&:7v <br /> ElecUicalContraclo� MailAddress City StatelZip Phone <br /> AY,��S"1A97S7�f/ <br /> Stale License Numher Contract Price of Work <br /> -C�tti,4� ti�!>s"r�oti <br /> Proposed Use of Building Contact Person (Plan Revie�v) <br /> Square Footage Q(res�dential new construction, remodel or addilion) <br />� Description of Work to Be Done: %—S'T1Q�� �F ��v vn�F..G?-- <br /> NOTE: WIRING IN NON-DW[LLINGS IS RGQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y c��iify(hat 1 have read and examined(his application and kno�v fhe same to be huo and G� ZJ�'�Z(r� <br /> coriecL All p�ovisions a//mvs and o�dinances goveming Ihis type o/u�o�k will be completed <br /> whether speci(ed hemin or noL The granting o/a pennd does not resurne ro give authonty to <br /> violate orcancel lhe provisions o/any oiherstafe orfocalla�v reguP(ing conslrucfion orihe <br /> pedonnance o/cons0uclion. That I�m aufhonzed by the or�ier o/fhisp rope�ty fo pedonn Ihe <br /> work!or which applicafion is made and I compty wifh the Sta(e Confractors Law 1827 RCW and <br /> 296.200 WAC. <br /> � �-��� 9-1..s�� <br /> Signature Daie <br />