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ELECTRICAL PERMIT APPLlCATION <br /> CITY OF EVERETT PERNIIT SFRVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 –www.everettwa.org �_ 6-�a <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C— I'a-U 7��'7 <br /> �� !�' - � :u � <br /> PROJECT ADDRESS <br /> � ' ���� � �J� � � -r i, w ��� �� TT �J�� <br /> Owner Mail Address City State/Zip Phone <br /> Tenanl Mail Address Ciry StateiZip ` Phone <br /> Z 6 <br /> �v � ) Y G'/ - 2 Z t� � I L� I •rU:�/!IC�J ��:�?<(� (..J'-( /lJ D`I3 �I`l �� O S <br /> � .. �✓ 1 <br /> [leclrical itraclo� P.1ail Address Ciry StatelZip Phone <br /> ��V:L �-Et SO bYS ✓r /SU'�— <br /> Slale License Number Coniract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Sauare Footage(If residenlial new construc�ion, remodel or addition) <br /> Description of Work lo Be Done: 1 vl S—' �l S 1•�ttic� —�e� �c cTe7 S �O�. � ��•� � — <br /> � <br /> / /.'. �, - <br /> i <br />� NOTE: WIRING IN NON-DWELLINGS IS REQUIR[C TO FEE <br /> � BE IN RACEWAYS, MC QR AC CABLE. <br /> ICITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> 1 he�eby certily thaf 1 havc read and examined this applicahon and know the same to be fn�e and �ZC�� ' ��'� <br /> co�recL All prowsions of!aivs and ordinances goveming fh�s type of�vork wtll be cempleta� <br /> wNefher specdied herein ornoL The gran!ing o/a pemut does nof resurne to give authonly to <br /> violafe orcancel fhe provieions o(any otherstafe orlocal law reguPfiny wnsfn�ction orfhe <br /> peAonnance ol consGuction. That 1 am authonzed by the owner oI fhis/�roperty lo p�er(orm(he <br /> work Ior�ahich applica(ion is made and 1 comply�vifh fhe Sfafe Contrac(ors La�v 18.J RCW and <br /> 296.200 WAC. <br /> '' 7 _ � ��i <br /> ��,�,;�:.�._. � , - z Z- <br /> . .,�, <br /> -- Signawre Date <br /> � -----�—�---------- <br />