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; . <br /> � �� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-88�0 - FAX 425-257-8857—www.everettwa.org <br /> APPLICPTIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> 1 "� <br /> i � � '-'� ..�1,.�.��� . . � /�='.. '._i �)��� <br /> PROJECT ADDRESS <br /> � � , <br /> � � � � � �'�, � <br /> -`i��; i -.t.�,��, � , : , � ,-�.. , <br /> Ownef I�`Mail Address� Cih� StatelZip Phone <br /> 131Vd �- ' . ,I,; , <br /> ��i1i111� .���;11 �. ,.����� '�.�vC', il'J�i.,• -,�•� .�� � , , <br /> Tenanl <br /> Mail Address City StatelZip Phone <br /> , � , <br /> iti � <br /> � '. � i.:r i . �� � •�� ��1 !'.���� , . �� ��C4Jl"��� \ i , . . , <br /> I <br /> Eleclrical Coniractor Mail Address . C�ry State/Zip Phone <br /> I�, ; <br /> _ , �� � J <br /> � � ; � —��L, �� 'i '-.T, �_`� - <br /> . t ��i � <br /> State License Number Contract Price of Work <br /> ��1 i� i - ..,, �: <br /> Proposed Use o�Building Contact Person (Plan Review) <br /> Square Footage(If residenlial new conslruction,remodel or addition) <br /> t _ . ._���' '�. <br /> Description of Work lo Be Done: ' '` � �� ��'�� '�� � �� � ;�:� , � <br />� <br /> I <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> �I BE IN RACEWAYS, MC OR AC CABLE. �� CC <br /> '� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hemby certily that I have read and examined fhis applicalion and know the same to be true and y '7) � - I( I <br /> conect. All provisions ollaws and ordinances goveming this typo ol work will be completed � ( �-:. �/ <br /> I� whelher speci6ed herein or noL The granting ol a permd does nof resume to give authonty(o <br /> violate or cancel fhe provisions o/any o�her sfafe or local/aw reguPting conswction or the <br /> � perlormance o/construction. Thal I am authonzed by the owner ol lhis properiy fo perform the <br /> work for which application is made and I compty wifb Ihe State Conlractors Law 78.27 RCW and <br /> I 296100 WAC. <br /> �� ���,� . � _ ' ��`' ': �' , � <br /> ��� Slgnature ' Date <br />