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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-v�nvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � ���j i�/� 1 i i—� �V L.: <br /> PROJECTADDRESS <br /> �I���na��'�'r„ �; ;��{_ �� C<�L��= �tz�- z�53� <br /> Owner M11ailAddress City State2ip Phone <br /> '�� p,.J �qJ� Q — <br /> Tellanl Mail Address Cily StatelZir, Phone <br /> �+�-��� <br /> ��� C `=c',L� C'- �`� 'l'�7X -�'i�=� �E�L�1T�r�J� — 2-�/ <br /> -7���;_.iN l�L <br /> EleclricalContraclor MailAddress City Slate/Z�p Phone <br /> lc�,� ���=c `�3��^7 ;�E— _ ��� /0��' <br /> Stale License Number CoMracl Price of Woik <br /> "��.s ��'A�''r[� rJ ;=1- !/r�. <br /> Proposed Use of Building Contact Person (Plan Revieei) <br /> Square Footage Qf msidential new conslruclion, remodel or addition) <br /> a i7 �` � <br /> Description of Wark to Be Done: d V � I'\j �� � A M r ��'�v� ��' <br /> � � — `.-1 <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAE3LE. �� . � � <br /> I <br /> CITY OF EVERET�f LOCAL SALES TAX CODE IS 3705 <br /> II hereby cerfily that 1 have mnd and examined this applicalion mid kno�v Ihe same(o be true and <br /> conect. All p{ovisions o//a�vs and orciinances govemmg Ihis fype of�sork wiil be carnplefed <br /> �vhelher spea(ed he�cin crnoL The granfing o/a permd does not vesurrie to give authonty fo <br /> vrolale or cm�cel fhe piovisions o/any othersfa(e orlocal law mgulating cons(ruction or fhe <br /> per/omiance oJconstruction. That I am aufhonzed by the ordner o/this property to perfomi fhe <br /> �vork for vrhich applicalion is m�de and I comply�vilh thc SIaM Conlractors Latv 18.27 RCW and <br /> 29E.200 WAC. / � <br /> C--� ��/� 5/% Z <br /> Signaturc <br /> � Dale <br />