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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICE� <br /> 3200 CEDAR STREET, EVERETT', WA 98201 � � 3-0 �7 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org � o��� `��G <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � - . <br /> ��U� S c� �✓—�=' I�U'�'�� <br /> PROJECT ADDRESS <br /> l�wne� Mail Address Cily SlalelZip Phone <br /> � / �.�� �� � .� <br /> Tenanl ` A7ail Address City Stale/Zip Phone <br /> %��/��3� <br /> Eleclrical Coniractor Mail Address city S�ate2ip Pnone <br /> State License Number Contract Price oi Nbrk <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Descriptio�of Work to Be Done: ���' � � V ��l"�`"�-�-- <br /> NOTE: WIRING IN NON-DWEL�INGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerfily that 1 have read ar,d exarnined this application and know fhe same to be true and <br /> conecL All prowsions o/laws and ordinances govemmc�fhis type o(work will be completed <br /> whether specdied he�ein or nol. 7he granfing o/a pemuf does nof presume to give authonty lo <br /> violafe or cancel the I�rovisions ol any other sfate or local law regulating consfrucGon or fhe / <br /> perlormance ol construction. Thaf I �m authorized b�•the owner of Ihis properfy to perform fhe � �� <br /> work(or which application is rnade and I comply with the State Contractors Law 18.27 RCW and n�� _� <br /> 29G.200 WAC. � <br /> if <br /> ----Signature Date <br />