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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 � �� <br /> ,os <br /> � ����� S G t� ��e r r j-� rv.a � I ,k-'<<�/ <br /> PROJECT ADDRESS <br /> � ��,(i<�_ �l ! � StatelZip Phone <br /> Owner hlail Address Cify <br /> 1�-t c,� �" �� � s � <br /> Tenant Mail Address <br /> Ciry Stale2ip Phone <br /> 3Gcs� �-E�- <br /> �N-Fc�s-4-a-}� et �c-# r ,c <br /> CG,e{} Qlis (�.�R� 9� '�2 � � � � <br /> Eleclrical Conlraclor Mail Address <br /> City SlalelLp Phone <br /> O 1 � � <br /> �N-���e'�p Z3 k N Contract Price o(Work <br /> Stale License Number <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Descriplion of Work lo Be Done: � � S�� �� 1'�'QL.�S � ��`�C� �' � S �T <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � :���� <br /> G�� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I I hereby certily that/have read and examined Ihis applicafion and know Ihe same fo be true and <br /> correcL All provisions o(la�vs and ordinances govermng fhis type oI work will be completed <br /> u�hether speci6e:i herem or noL The granting ol a pe�md does not resume to give authority to <br /> violate or cance�the provisions o�any other slate or local law reguPting conslrucGon or the <br /> perfermance o/construction. Thaf I arn aufhorired by the owner el this properly(o perform the <br /> �vorlc lur�vhich application is made and 1 comply wifh flie State Cor,tractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �,� �-r_--- <br /> � � �s ��oy-63� <br /> Signawre Date <br /> %-;� ,t.'�'',�'' , _.;'/-;�� � , � �, <br /> , <br />