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ELECTRI�AL PERMlT APPLICATION <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 />APPLICATIONS ARE AGCE?TED FROM 8 AM TO 4 PM <br />���i � / � F� %' /_-� ,r ; � / ,'/� <br />PROJECT ADDRESS <br />�`-�s-►3 <br />[_ r3oa-�o� <br />--r � � f'n �',ri ��ii � ���, 7^L +;f%I�,�,j. 3�; ✓ G•�i''v' <br />v �'- �,-- � ' � � . :.�... <br />Owner � PdailAddress City Slate/Zip Phone <br />Tenant <br />Eleclrical Coniractor <br />Mail Address <br />Mail Address <br />� �; � <br />/�' % � i'-: l � f /' ; � <br />Slale License Number <br />n �� �: <br />/<Y / �, '�/! �' / - — <br />Propos2d Use df Building � <br />Square Footage Qf residenlial new construc�ion, remodel or addition) <br />Description of Work lo Be Done: �1_ <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />City <br />City <br />� <br />State/Zip <br />Slale2ip <br />�� � � � <br />Contrac Price oi Work <br />Phone <br />Phone <br />� V'•/^�%I �C%ii-� � /i�_ <br />Contact Person (Plan RevievQ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerfily that I have read and examined this application and know fhe same to he tiue and <br />correct. All provisions o(laws and ordinances goveming (h�s type o( work vrill be completed <br />�vhetherspea�ed heiein ornot. The granting o/a pem�rt does notp resurne to give aufhonty to <br />violafe or cancel the provisions o(any othersfate orlocal !aw reyulating construction orthe <br />peAormance of consWction. That 1 am authonzed by Ihe ownerol this propedy to per(orm the <br />work (or r�hich application is made and 1 compty with the State Contracfors La�v 18.27 RCW and <br />296.200 WAC. <br />�;. <br />_ � ij% `/�/� � � /L '� � 7 <br />'i�.y� j;''" �/� �/ �� % / ��i �_ <br />Sinnature � <br />�'i � <br />FEE <br />�� C�� <br />��3�� -�o� <br />