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�LECTRICAL PERMIT ARPLICATION <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 /> APPLIGATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 4/L� � S�*�, �� �-'�' <br /> PROJECTADDRESS <br /> Owner Mail Atldmss City StatelZip Phone <br /> �-�lii 1 L �y��'S ���� L Sl�t/�1i1 �2''.�r�—.r/� CGc'� S/�S 87G�Y6'i <br /> Tenant Mail Address City StatelZip Phone <br /> �' (i � f �C'� � � � �. > ' • ��.5 �lr� <br /> �G� �/.�'� � 2 z v�� /Cc Gy�.' .� % �,�-,r�� - <br /> EIe trical GoNraclor Mail Address Ciy State2ip Phone <br /> �� <br /> lc%+i.i� r' . lYs l'l� ��J <br /> Slate icense Number Contracl Price of Work <br /> C �l�� 1 L � ��. <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Square Footage Qf residential new consiruction, remodel or addifion) <br /> � � (/2'3-r J�-!" <br /> Description of Work to[3e Done: �i ��c 'o.--rr'� r �` �– f �c"r'"n � <br /> �,�� — � <br /> NOTE: WIRING IN NON-DW�LLINGS IS R[QUIR[D TO FEE <br /> BE IN RACEWAYS, MC OR AC CADLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 — <br /> 1 he�eby certily tHaf!hove read and examined Ihis applica(ion and knmv the smne to be true and <br /> con�ecL All provisions o//aws and ordinances govemmg this type ol work�a�ill be wmplefed <br /> �rhefher sneci(ied herain or noL The g�anling of a pemut does not presunte to give authonty to <br /> violafe or cancel(he Inovisions o(any othersfa(e or local lau�mgulating construc(ion or ll�e <br /> perfomiance oI construction. 7hat 1 ant aufhorized by(he mt-ner ol fhis I�roperiy to peifonn the <br /> n-o�k!or�vhich applicafion is made and 1 comply wilh the Sfa(e Contrac(ors Laiv 78.27 RC W and <br /> I 296.200 WAC. <br /> �'�l'i...��L�� ��/��( �c� <br /> / Si ature Da�e <br /> L � � <br /> / _ __ <br />