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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 —wvwa.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROJECT ADDRESS <br /> , -� <br /> �,�� �;' I ) �.�1 " l/ '��11�1i :�:� . Z`�,i �_ ��%� �,. .,-�' ��, � � �� ..�-� _ � , f <br /> y'-� �- �� 15' I <br /> Owner Mail Address City Stale2ip Phone <br /> Tenant Mail Address Cily State/Zip Phone <br /> ��c <br /> Eleclrical Conlreclor A1ail Address City StalefZip Phone <br /> Stale License Number Contracl Price of Work <br /> ���(.y2�'L'-� <br /> Proposed se o(Buildinc� Contact Person (Plan Review) <br /> ��� �( i <br /> Description of Work to Be Done: �1�-�-C.���� ����'1 ('�1�� <br />` , NOTE: WIRING IN NON-DWELLINGS 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 ceriily that 1 have read and examined this application end kno�v fhe seme to be tnio and 'E��"��1 1 -U j l <br /> correct. All piovisions of laws and ordinances govemin�fhis type ol�rork will be cornplefed <br /> whefher specdied herein or noL The�ranting ol a pernut does not presume ro give authonty to <br /> violatu or cancel the�rovisions o(any other state or local law rec�u/afing consfruction or the <br /> per(ormance o/construction. That 1 am authonzed by fhe owner o/fhis properly to perfomt the <br /> work lor which application is made and 1 comply wifh fhe State Confracfors La�v 18.27 RCW and <br /> 296.200 Ih�AC. <br /> � � �. , � 7 <br /> _ <br /> ,,;;;�; �:<, � <br /> � Si�naWre' Date <br />