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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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> /�� � J <br /> �- . C c: 1.���titie t�� , n / ,. ��-.,, �� l,l,/� . ' � <br /> ' �_l �C.''J � ( ��� � �,'�' � 1 `i �- ( � <br /> r <br /> PROJECT ADDRESS <br /> u_��f�Ct � ���o, ����('�JSEv�. � SCc iti��_ C� � �� 1��:.,�t � � `-I� > ;� �=�"0 �2 <br /> � . <br /> Owner Mail Address City Stale/Zip Phone <br /> Tenanl Mail Address City Slale/Zip Phone <br /> �� ��t� •,—:`�_' <br /> Eleclrical Conlraclor Mail Address Cily Stale/Zip Phone <br /> State License Number Conlract Price of Work <br /> Proposed Use of Building Conlact Person (Pl�n Review) <br /> � � <br /> Description of Work lo Be Done: % F^ u �^ �� /� c^ � 1 i / C'�� — �-? `, <br /> U <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I CITY OF EVERETT LUCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceAily fhat I have read and examined fhis application and kno�v the same to be true and <br /> correcL All provisions o/laws and ordinances goveming fhrs type ol work will be completed <br /> whelher specfied herein or noL The granting o(a pemuf does nof resume fo give authonty to <br /> violate or cancel fhe provisions ol any other state orlocalla�v reguPting construction or fhe <br /> peAormance ol conslruction. Thaf 1 am authonzed by the o�vner of fhis property to perform fhe <br /> �vork lor which application is made and 1 compty�vifh fhe Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � <br /> / ����C /�� I�; � l. 1ti �..', �� � /C:�S <br /> � Sic�nature ' Dale Q <br /> �5 ��v <br /> � <br />