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1 <br /> c <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERET7 PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org �` �y ��3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��`�� —D�Z <br /> �) / � <br /> •%��) � ��C 7� / PC <br /> pROJECTAUDRESS <br /> /� /%/3 ���c..� i7" � �S'1ai �6"-y6> ��� <br /> �„ <br /> Owner Mail Address Ciry State/Zip Phona <br /> Tenant Mail Address City State/Zip Phone <br /> ��.-�,�, � C'/��rf� i/�7 Nw �/tc� t 5� ;�; I,�,� y�/� � .�06 �-�� , T�' <br /> Elect�ical Contractor Mail Address City StatelZip Phone <br /> /.���v; � ( �"D%� l- , Jd - <br /> �State License Number 1 Contract Price of Work <br /> ,^ G � C�` l ��_ � l <br /> ��sf�. : l,;J � e,�- �n n r — <br /> Propos Use of Building Contact Person (Plan Review) <br /> Square Footage (If residen�ial new consiruc�ion, remodel or addition) <br /> Description of Work lo Be Done: <br /> �'+cG'k,� ��'��. ��5�`^i f�r %V' �?fSl <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �r� r� <br /> � -- <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 nere6y certi(y that I liave read and examined this applicafion and know the same fo be true and � �D � — �1/_� <br /> correct. A/l provisions o(laws and ordinances goveming fhis type u(wark will L•e.completed � ��YJ <br /> �vhefher specified herein or noL The grantiny u(a H emtd does notp resume to groe authonty ro <br /> violate or cancel the provisions of any o(her state or/ocal law regu/ating construcfion orthe <br /> peAormance o/construction That 1 am aufhonzed by the or�nerof this property to peAorm fhe <br /> woik(or which application is made and 1 comply wifh the State Contraclors Law 18.27 RCW and <br /> 296.200 Wf1C. - ;- <br /> ;` , ;% `�-' i � y ��� 3 <br /> Signature Date <br /> I <br />