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ELECTRICAL PERMIT APPLICATION <br />CITY Or 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 />J �� v (,`� �1 � T � l� k f � �I �1 �(i �� �l �� � � <br />PRO CTADDRESS <br />���--iz <br />(,�/Zo 7 --o � � <br />� C� ' (1i�7 i�i�G`� <br />�� Sp �,�- F i; ��.x �/'i 3(,� � ,� -, �, <br />Owner Mail Address ity Slate/Zip Phone <br />Tenant <br />�,�(,v17-� r' <br />:trical Conlraclor <br />Sta�e License Numher <br />Proposed Use of Building <br />Mail Address <br />Mail Addr=ss <br />t <br />Square Foo�age Qt residenlial new construction, remodel or addition) <br />Descriplion of V��ork to Be Done. <br />) ( <br />C�'(�Iil%i,iC, ��t1��1 <br />f <br />NOTE: WIRING IN NON-DWELLINGS IS REQU'.RED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />c��v <br />Ciry <br />StatelZip <br />State/Zip <br />�S �� <br />Conlract Price ot Work <br />�'�t�r�;,� )Y����T r ✓ <br />Conlac� Person (Plan Revietv) <br />�Celll dC'(+ � 5/� C^l/� <br />1 hercby cei!dy that 1 havc read and examined this aoplication and kno�v ;he sarne to be tnre and <br />correct. All pinvisions olla�vs and o�dinances goveiiung this type ol wark �vill bq coir.plefecl <br />ivhether speci�ed he�ein or noL The yranfing o/ a pernut does not presume to give a�dhonty fo <br />violate orcancel fhe provisions oI any otherstate or local law regulaling consWction or lhe <br />perfonnance of consLvc6on. Thaf I arn aufhoiized 'cy the o�:�ner o/fhis propedy to perfomi the <br />���o� ro� �v�,ren ��n��cahon is made and 1 comply r�itn fhe Srafe Contractors Lav� 18.2? RCW and <br />296, 200 WAC. <br />I�� �� � � � ��� l,� <br />V �,1�.�, �' ^ �� �. Date <br />Signature <br />i_ _-- --_ <br />FEE <br />Phone <br />Phone <br />�la o"� - Dc�� <br />