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[CLi=CTRICAL PERMIT .4PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-885i —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> :�3� J 0��� <br /> PROJECT ADDRES; � <br /> �J�P%�n� / <br /> Owner Mail Address City Slatell_ip Phone <br /> Tenant tdail Address City State/Zip Phone <br /> Electrieal Contractor Mail Ad�ress City State2ip Phone <br /> Slate License Number ('ontract Pnce o(Work <br /> Proposed Use of Euilding Conlact Person (Plan Review) <br /> Description of Work to 8e Done: �/' �� <br /> NOTE: WIRING IN NON�DWEILINGS IS REQUIR[D TO FEE <br /> 8[ IN RACEWAYS, MC OR AC CABLE. <br /> i ��� <br />� <br /> CITY OF EVERETT LOCAL SAL[S TAX COD[IS 3105 <br /> 1 heroby cnrir!}�that 1 havc read anJ examined fhis applicafion and know the sarne to Ge We and <br /> correct All provisions ol laws and wdinances goveming this type ol�rork wil!be complefed <br /> �vhefher specihed herein or noL The granfing ol a permd does not presume to give aulhonty to <br /> vio/afe or cance!the provisions o/any other sfate or local law regu/afing consfrucfion or the <br /> periom�ance ol conslruclion. I"hat 1 am aulhonzeu 6y the owner ol this property to peHorrn fhe <br /> work lor which applrcafion is made and I comply wifh the Sfate Conf�actors t aw 1827 RCW and <br /> 296.200 WAC. <br /> ��-'��;,�1��� � . �-� � 7- z� Cr <br /> 5ignaWrc Date <br /> 1CoCoG�a-Ga � <br />