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ELECTRICAL P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEOAR 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 a _��D <br /> _ '� i ���1 ����,���,ti� ��� �,(�� ���s s����, � <br /> PROJECT ADDRESS <br /> ;, ,;�� ;�� �� i �2 z�� r�;� o�� ,� �� �f 9���� <br /> � <br /> Owner � Mail Address City State/Zip Phone <br /> . . .__.. . . . <br /> TeoanT Mail Address Ciry S�ate/Zip Phone <br /> ElecUical Contractor Mail Address City State/Zip Phone <br /> y�� S�S- �`�� � <br /> State License Number Contrect Price of Work <br /> i <br /> /' i <br /> l U"�!) �;i:: ��;.�� /��� — <br /> Proposed Use of B�ilding Contact Person (Pla�Review) <br /> i' <br /> ` � + <br /> Descriplion of Work to Be Done: � '� `�� �`�\'��`�� � <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 3705 <br /> I hereby certily that I have read and examined this application and know the same to be frue and <br /> correcL All provisions ollaws and ordinances goveming this type o(work will be completed <br /> whether speci6ed herein or noL The granting o/a permrt does not pr=sume to give authonty to <br /> violate o�canr,el the provisicns of any other state or local law ragu/ating construction or the <br /> pedormance o/constructioa That I am authonzed by the owner ol th�s roperty to perlorm the <br /> work/or which a lication is ma nd I comply with the State Contrac ors L w 18.27 RCW and <br /> 296.200 WAC. � � ,� <br /> � � <br /> '� ���� ��� � � I � -. f�� <br /> SignaNre � Date ��'— � � <br /> rl�� I <br /> I <br /> — — —._ -- . ._J <br />