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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 �_'�-�— O� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM (�(��O �I y <br /> ��'/% /����;��<<�-r , "� -� . <br /> PROJECT ADDRE S <br /> �i�� /.1<< /�r�i,io <br /> OWnef A1ail Addiess City SlatelZip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Electr cal Contraclor Ma�l Address Cily S�alelZip Phone <br /> C'���'I'I C'/'� <br /> Slate License Number CorUact Pnce ot Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: I�f`G//�'-f � �J� �/f C" <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> f3E IN RACEWAYS, MC OR AC CADLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 p <br /> � I hereby certily fhaf I have read and examined this applicaliun and kno�v fhe sarne to be We and C (���J - ��� <br /> correct. All provisions ol/aws and ordinances govermng fh�s type ol wo�k�vill be complefed <br /> whefher speciGed herein or not The granling ol a pemuf does not resurne to give au0�onty to <br /> violate or cancel Ihe provisions ol any other state or local la�v re�uPting construchon or fhe <br /> perlormance oI consfn�cfior�. Thaf 1 am aulhorized by the o�vner o/fhis property to perfonn fhe <br /> work/or which applicafion is rt•ade and 1 cornply�vith the Sfate Confractors Law 18.27 RCW and <br /> 296.200�� � <br /> � � _..-� <br /> � � �i <br /> `� /f2-✓J �C c L �! .�.✓ O �� L�i�' <br /> Signature Dale—� <br /> � <br />