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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - �AX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �j ���� � b\Cr"C: ��� �-- <br /> PROJECTADDRESS <br /> � -� / ��)� <br /> �01� l� IJC: ���� S C'- ����t� ��l/c;�'E,�-'t— ��',�. Cf � ,� G� <br /> OWnef MailAddress Ciry StateRip Pho��� <br /> Tenant MailAddress Ciry StalelZip Phone <br /> � ��t��il�J�%lT/l' -� � ,1� ���� � �✓� _��. ���1ti�i.i)Crr.� �C��� �f �' ls�� <br /> [lect�nirador � MailAddress City� S�alelZip Phone <br /> �,f•�-l>,�L l L Lf(:�- ��i' Co�t Price o�rkZ— <br /> Slale License Number <br /> �roposed Use o(Buitding Co�iact Person (Plan Revie�v) <br /> Square Footage Qf residential new construclion,remodel or addition) <br /> Description of Woik to �e Done: �< <`��• y � � r l• r r�' /?��` �` ` ���� <br /> NOTE: WIRING IN N.�N-DWELLINGS IS R[QUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAE3LE. �O� <br /> CITY Or'EVERETT LOCAL SALES TAX CODE IS J105 <br /> 1 hereby ce�fily Iltat I have read and examined fhis applicafion and knmv the sarno(o he(rue and rl���_ O! ! <br /> co�recL A/l provisions o(la�vs and ordinances 9oveming flns type ol work�viU Ue complefed �— (Q(n <br /> n�helherspecihed hercin ornoL The granting ot a pennd does not resume to give authonty fo L f <br /> viola(e orcancel the provisions o/any ofhersfafe orlocal/ar✓reguPating consm�clion orthe <br /> pedormance oI consln�clion. That I arn authonzed 6y the o�vnerof this�roperfy to peAorm the <br /> �ro�ork Ior�vhich applicafion is made and I compty wilb fhe Sfate Contracfors Law]8.27 RCW and <br /> 296.200 Vj�AC. <br /> ; , _ '-7 <br /> i " � �"� � <br /> � ��Z_ . <br /> -�°C!. �„!,��1:�C_.. . S��/� � �� � G <br /> Siqnature Dale <br />