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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 /> f/ ..., / <br /> PROJECT ADDRESS i � <br /> j � <br /> , � , � <br /> �C'/-� /'�r �l-� �i(� L L. ;� ;:1;� <br /> Owner � Mail Address Ciry Stale/ZiF � Phone ', <br /> i <br /> , / , C/ ) <br /> �. - � ,,;: : . � � / ,l--i. � � �� �<�' OCI� / <br /> -,! <br /> Tenant � Mail Adtlress � City � State/Zip � Phone <br /> / <br /> ('r�i:, / — <br /> Eledrical Contracto� Mail Address Ciry SWte/Zip Phone <br /> � �� /\r7t�l"\ �.�i <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Pian Review) <br /> / i <br /> Descrip[ion of Work to Be Done: � ����5 �Ur^����1� ����� �"�^ ��x.� �����i�-� <br /> � <br /> _ I <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE � <br /> BE IN RACEWAYS, MC OR AC CABLE. nJ �j <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceRi/y that I have read and examined this application and know the same to be irue and <br /> aorrect. All provisions of laws and ordinances governing fhis type o/work wili be c�mpleted <br /> u�hether specilied here�n or not The granting o/a permd does not presume te give authonty to <br /> v�olate or cancel the provisions of any other state or local la�v regu/ating construction or the <br /> �performance ol construction. That I am authorized by the owner o/thrs propeRy to perform the <br /> wcrk/or which application is made and I comply with the State Confrectors Law 18.27 RCW and <br /> 296200 WAC. <br /> �=n�/`� ` `�d 7 <br /> Signature Date <br />