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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERET7 PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX �25-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �(�o / E� ,� 5' i <br /> PROJECT ADDRESS <br /> / <br /> Owner M1tail Address City State2ip Phone <br /> i����� S � �T N�� r� S �-�.a,� s,,�� <br /> Tenanl Mail Address City State2lp Phone <br /> I 1_ C_ �L-'TE.�SanJ j L�CTFCC ;,ti< L�11n��v�oQ ��� � � Z�E-�S3 -N4�� <br /> Eleclrical Conlractor Mail Address City State/Zip Phone <br /> �� � I-F 'T[ I O �o .(� C <br /> Stale License Number Conlract Price of Work <br /> fl i'r(� �qC,a^� <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> Description of Work lo Be Dono: � ��� �C �/ ���`� C���✓ �U �� � � � � � <br /> , <br /> l���F T � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREDTO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily thaf I have read ond axamined this application ond know fhe same to be true and <br /> conect All provisions o/laws and ordinances governing this type ol work will be complefed <br /> whether speafied hemin or not. The g�anting of a pernuf daes not prosumo fo give authonty to <br /> violafe or cancel fhe Provisions o/any o;her stafe orlocallou regult�fing consfrucfion or fhe <br /> perfomiance o/constructioa That I am aufhonzed by fhe onnor o/fhis property to perfomi the <br /> work lor�vhich applicafion is rnado and 1 compty tvifh the Stote Contractors Law 18.27 RCW end <br /> 29G.200 WAC. <br /> � � �'� ,�1 7 - � �- ��f r(�/l�/ � <br /> , <br /> , " /y � � <br /> .� � Si{Inal�nu Uoie � �" <br />