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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 /> �.�/ `� �- ' - <br /> PROJECT ADDRESS _ <br /> �� ,`� <br /> ` ,— /� <br /> _ � 7 c�l�: . <br /> , <br /> O,Yner jr� MailAddress Cily StatefLip Phone <br /> Tenanl Mail Address City State2ip Phone <br /> �'J'�i/ � i �_ � � �L!c_ i:L <br /> � <br /> Electrical Conlractor Mail Address City State/?ip �hone <br /> � S�rle License Number Conlracl Price of Work <br /> I <br /> I Proposed Use o(Building Contacl Person (Plan Review) <br /> , � / <br /> Description of Work to Be Done: -�� L Y� �� � T�;� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I CITY OF EVERETT LOCA!SALES TAX CODE IS 3105 <br /> i <br /> 1 here6y certi/y fhaf 1 have read and examined fhis applicafion and kno�v fhe same fo be true and <br /> correcL All provisions ollaws and ordinances govemmg fhis type ol work will be completed <br /> whether spec�fied herein or noL (he granting of a permit does not presume to oive authonty to <br /> violafe or r.ancel fhe provisions c(any other state or local law regulafing construcfion or the <br /> perlormance of consWction. That 1 am aufhonzed by the otvner of this property!o perform the <br /> work/or�vhich application is made and 1 comply with the Slate Confractors Law 7 8.27 RCW and �7 <br /> 29G.200 WAC. /� <br /> (� I � � <br /> Signature Date / ,' �/ <br /> Lr <br />