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ELECTRICAL PERMIT APPLICATP:ON <br />R�TT PERMIT SERVICES <br />�Sc i Sz �=` � <br />PROJECT ADDRESS <br />CITY OF EVE `7� 3 <br />3200 CEDAR STREET, EVERETT, WA 98201 3 <br />425-257-8810 - FAX 425-257-8857 —www.everettwa.org G���3 �5�3 <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br />S!`. S. i= �` � t"uc�✓c� es�-�� �$ Zv 3 <br />�lJ�r 2 �'�vV'rc r�P���� <br />Ownef Mail Address City StatelZip Phone <br />Tenant Mail Address <br />����Cd %=���'��c ��, <br />Electricai Contractor Mail Address <br />�Q(�.��G ��L'� / / �� � <br />Siate License Numher <br />Proposed Use of Building <br />City <br />�'�sf ��'��. <br />Square Footage Qf residential new construction, remudel or addition) <br />Descriplion of Work lo Be Done: <br />' f t� �� /CJ <br />Ci!� <br />Slate/Zip <br />Phane <br />s�C� �� ��z�o <br />SlatelZip <br />CoNr����Work <br />Phone <br />Conlacl Person (Plan Review) <br />-�� /-ct � �� �����tYc�s�-;. <br />NOTE: WIRiNG IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CA[3LE. �'O • DU <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily Ihaf 1 have read and examined this application and know the same to be fn�e and � ��G� �� rC, � <br />conect. All piov�sions o(laws and ordrnances goveming this type of �vork will be completed L (J � <br />whefher spea6cd herein or not. The granting o( a pennd does ne` presume lo c�ive aut4onty to <br />violate orcancel thr. piovisions ofany otherstate orlocallawregulating construclion ar(he <br />pedortnance o( consWc6on. That I am authonzed by Ihe owner o( fhis �roperty to pedorm fhe <br />�vod< Ior which applica(ion is made and I compty wilh fhe State Contraciors Law 1827 RCW and <br />296.200 WAC. , , <br />� `�� ��� <br />__ , ; � <br />_ , �--- -z_ _ <br />- <br />