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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 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �����-' .� /��C/t�/� �'r�i Tl i��� ��✓ I'.,. <br /> PROJECT ADDRESS <br /> � `y � <br /> /�J�d'`���/°i�rlP J�'1/lt!'1�' <br /> Owner Mail Address City State/Zip Phone <br /> a.)/`�!/l��l�(% <br /> Tenant Mail Address City State/Zip Phone <br /> �� �> ,� <br /> r`��J S(��a'�✓/'��:`�i?L t���'iri9��',1(/ �/�J_.`;,�,�.. j!��lC.'fi d� i-n,i�t�/i(/., v��-'-J �i.li%��1 ' "�y,` <br /> sy u t� �(.% ��J���-�'�T f <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> �.. - <br /> / ��� �` ��`�/�/ /�% �`>,�,> `� �y <br /> State License Number Contract Price of Work <br /> %-} <br /> L� ,���Cip?� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> � 1,O��lU -- � <br /> Square Footage (If residential new construction, remodel or addition) ��}... <br /> ,c / i ,,� <br /> Description of Work to Be Done: J�� �ErC-►�c�'�� u 0'rl��E�;!' v c� �c>�• /C�� �6 r; ,{(,L;� �.,- <br /> � /, <br /> t�'O/�.�%VY'E'G C c.''✓r 7 7S�Lv.C"ti!'E�P!✓' il�G'cJ'�J��1 `✓ .��'��f'' !r'C�'�'�/� l�CG�.[ �4�---' <br /> � ��a- <br /> ��v�����Js��_N.���-.� �� , <br /> �V�hD(�v2 y�—��� l�0 3 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ��� ,� <br /> ��JU <br /> a � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that I have read and examined this application and know the same fo be true and � I�O �_-D�� <br /> correct. All provisions of laws and ordinances governm�this type of work will be completed <br /> whether speafied herein or not. The granting of a perm�t does notp resume to give authonty to <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construct�on. That I am authorized by the owner of th�s property to perform fhe <br /> work for which application is made 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � � <br /> .� <br /> _--�,�-�� �_�/� vG '„� �//� <br /> Signature Date <br />