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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �90 �F `"f�(� <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org y `�� �� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �/ �� <br /> l�c ���>� � r-7�1�-i <br /> ROJECT ADDRESS <br /> Owner Mail Address Cily Slate2lp Phaie <br /> Tenanl Mail Address Cily Slate2ip Phone <br /> I clr al COn' 1 a Or Mall Address Cily SlatolZip Phone <br /> Slate Licenso Number Contract Price of Work <br /> Pruposed Uso of Builoing Contact Person (Plan Roviow) <br /> Descrip�ion of Work to Bo Oone: _ �� � � �-��� ��[�� � �� " ��� <br /> ! <br /> NOTE: WIRINCi IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC �•r'.9LE. <br /> CITY OF EVERETT LOCAL SALES�AX CODE IS 7105 <br /> I hereby cerfity Ihaf I have read nnd exornined fhis npplicafion end know fhe same fo bo true and <br /> correcf. All provisions o!laws anA ordinnnces goveming Ous type o/woik will be comalefed <br /> whefher spocibed heroin o�not. Tho granfing ol a pennrt Aoes nol resume to give aulhcnty fo <br /> violafe or cancel fhe provisions ol any ofher sfafo or local law reguPfing consfrucf�on or fhe <br /> perlormance o/consl�ucfion. Thaf I am authonzeAby the owner oI fhls properly to perform fhe <br /> work lor which applicafion is maAe and I comply wilh Ihe Sfafe Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ����� �, � / � . yC^�. <br /> Signature � Date <br /> ; � � Ea4o�{_cx, �C <br />