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ELCCTRICAL PERMiT APPLICATION <br /> ClTY OF EVERETT PERMIT SERVICES <br /> '�200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-�57-8810 - FAX 425-257-d857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED PROM 8 AM TO 4 PNi • <br /> c �_ <br /> i��., - � �.v.C'-t (i�__._ � �_ <br /> PROJECT ADDRESS <br /> Owner Mail Address City Staterip Phone <br /> / �/l`�An.✓� _ ,G: -�`l� <br /> �_ <br /> Tenant �� Mail Address Cily StatelZip Phone <br /> . y� L� r ._. . <br /> i <br /> L. 1 � r'�- •;�'' � c <br /> Electrioa,ICrnl�aclor MailAddress City Slale/Zip Phone <br /> Stale License Number Contracl Price of Work <br /> Proposed Use oi Building Contacl Person (Plan Review) <br /> Description o(Work to Be Done: ,,��� —�' �� � `� `-- <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAI'S, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhat 1 have read and examined ihis application and know the same to be frue and <br /> correcL All provisions ollaws and ordinances governmg this type ol work will he completed <br /> whether speahed herein or not The granfing ol a perrnd does nof presume to give aufhority to <br /> violafe or cancel the provisions oI any ofher stafe er local law re�uleting construction or fhe <br /> perfonnance ol conslrucfion. That I am authonzed by the owner of this property fo per/ortn fhe <br /> work/or which applicafion is rnade and 1 comply wifh the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signafure Dale ' �� �� <br /> � <br />