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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 /> H LL tR tnrlck Avg, <br /> PROJECT ADDRESS <br /> o21.1 l0lsn 2p~-` s* Q� ►n1 eYs A. oA ipi276 /125-_z3 29407 <br /> Owner Mail Address City State/Zip Phone <br /> 0 o is 6 <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: �"` rtbieeA0./V15 a4 Q emsL;k b cd o <br /> la i' '5 l A, KK#Z.kel tilt ovm(k 1/4>1.1-' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ��l1 <br /> I hereby certify that I have read and examined this application and know the same to be true and llo 7 V vc) <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does notresume to give authority to <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of consruction. That I am authorized by the owner of thisroperty to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> i 1 (1 - t <br /> Signature Date <br />