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� � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 �EDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - �AX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � ) � ..) <br /> c7` �.�/— �( C�1'�� �Ufi <br /> PROJECT ADDRESS <br /> / �`Rlrl �l' „ ��� ����n� <br /> Owner Mail Address City <br /> StalelZip Phone <br /> Tenanl Mail Address City <br /> StatelZip Phone <br /> �L�; �s �/�, �.�� �sz' "� yw s�>��,0 ��� <br /> SlatelZi? Phone <br /> Electrical Conlracto� Mail Address �'�Y ' <br /> r0 <br /> �/"� ` � ^ ��J���� ContraC�P�of Work <br /> Slate License Number <br /> �`��l ��\� � � �� Contact Person (Plan Review) <br /> ProposeJ Use of Building <br /> �s nn <br /> Square Footage(I(resid ntial new consiruclion, remodel or addition) <br /> �� - �/ �' �-�- �t� ��i 4� o�� � �� r�-. <br /> Description of Work lo Be Done: <br /> � / ct /H ,� �l ��� <br /> NOTE: WIRING iN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CA[iLE. <br /> I U� �� SC� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> 1 hereby ce�fily that 1 have mnd and examined fhis�pplication aro o%�vork�viil be com�lefed and � I j(!�� ' /��j/ ' <br /> correc(iA�l pravision.c o(laws and ordinances 9oveming thrs typ P �� �F <br /> ���hefNerspeci� hc�cin ornoL The granting o(a pennd does nofp resurne(o give aufhonty to <br /> vio°�te orr.ance! he provisions ol any ofher state orlocal la�v regulafing cons(nic6on orfhe <br /> p s/onnance o/c ns(rucf n. Tha(I am � ed 6y fhr. o�vnero/thisp roperty lo peAami fhr. <br /> ��o�k/or c�hich ap licafi is m e ar 1 c i �y wilh(he Sfate Contracfocs La�v 1827 RCW and <br /> '96.200 WAC. <br /> � / `�2 i 3 �'i 3 <br /> Signature Date <br />