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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 /> P.PPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � , % �.�� �,? � � <br /> PROJECT ADDRESS <br /> � � S <br /> I� ti i �� - , ��,�, : � •-;�;��qa�� 1'��s�� �-�c- C ��, <br /> ., <br /> Owner A7ail Address City Slate/Zip Phone <br /> Tenanl Mail Address Clly Slate/Zip Phone <br /> [loclrical Conlraclor M1tail Add�ess Gty Stale/Zip Phone <br /> Slate License Number Contract Price of VJork <br /> Proposr.d Use ol Buildin9 Contact Person (Plai Rovlow) <br /> .-- <br /> ` �'; <br /> Descnp�ion ol Work to Oo Donu: f-� � � `� i_ _ <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS R[QUIRED TO FEE <br /> FiE IN RACEWAYS, MC OR AC CABLE. <br />� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I heroby certily fhaf 1 have read end exnmined fhis applicntion nnA know fhe seme to be fruo end <br /> corr�cl. All provisions o!laws and ordinances governu�g this type o/K�ork will be comp/eted <br /> whefhor spealied horein o�noL The grenfing o/n perrnd doos nof �resume fo give aufhonfy fo <br /> VIJIB�C Of CAf1CCI IIIC provisions ol eny ofher sfafe or local luw regu�nfing cons(ruction oi fh� <br /> pwlonnanr.e ol construcfion. Thef I arn oufhorized by the owner o/lhis pro�erty to pedomi Ihe <br /> wor6 lo� which npplicefio.�is mado anA 1 cornply wifh U�e Sfato Contrectors Law 18.27 RCW and <br /> 795 200 WAC. , --� � <br /> -- � � � �f�'���_� _��� ,�� / -;� ��Ci � <br /> _"_ti�yn"�.i�u�i, uate J 1 i � � - I � j <br /> / <br />