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ELECTRICAL PERMIT APPLICA�TION <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 /> PROJECT ADDRESS <br /> '� - ` :4 <br /> '� . i, > , � - -1 �; � 1' �ia , ��/ , l'"t�!� �i� I -)✓�� .:> 1� ; �- ,, <br /> i�; , i u � '���- ��'�`�3 � <br /> /� - <br /> Owner Mail Address City Slate/Zip Phone <br /> Tenanl Mail Address Ciry State/Zip Phonc <br /> l l�V l���G`�1� <br /> Electrical ConlraClor Mail Address City State/Zip Phone <br /> Slale License Number Conlract Price o(Work <br /> ���.(.y�G�--� <br /> Proposc��Jse o(6ui ding Contacl Person (Plan Review) <br /> � � �•� � i� ' �i <br /> Description o(Work lo Be Done: ��`�l� l �t/I �'i 4.�� <br /> NOTE: WIRING IN NON-DWELLINGS !S REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I <br /> 1 hereby certify fh�f 1 have read and examined fhis applicafion and 1<now the same to be fruo and ��;"��i l -!'=> 1 <br /> �, cerrecL All provisions o.`laws and ordinances governing th�s type of work will6e completed <br /> �rhether specilied herein or noL the�rantinc�o/a permd does not resumo fo qi��e authonty to <br /> vrolale or cancel Ihe provisions o�any other sfate or local law reguPting consfruction or Ihe <br /> peiforrnance o/consVuchon. That 1 am authorized by Ihe owner ctthis properiy to pedomi the <br /> �vork/or which applicafioii is made and 1 comply with fho Stafe Contractors La�v 18.27 RCW and <br /> 29G.200 WAC. <br /> , ��� <br /> ,� ���' � 7 <br /> � , :� � � <br /> , �.; ,=� , - <br /> � Signalurc'' Oale <br />