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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 /> /���� �Urn ��r�/�-f ✓ <br /> PROJECTADDRESS ��Jl.��J'��� <br /> ,/�✓�cL � �- <br /> --�, � �� �� s������, � _��>� .��� ���/-1�P �e�� L✓�4 �� <br /> Owner Mail Address Cily State2ip � Phone <br /> Tenant Mail Address City State/Zip Phono <br /> \ ��)���� <br /> Electrical Conlrector Mail Address City SlalelZip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Buildiny Contact Person (Plan Review) <br /> i <br /> Description of Work lo �e Done: � I �/L� � � � � � �— <br /> �-- !� } - <br /> NOT[: 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 cerfi/y fhaf 1 have read and examined(his applicalion and know the same to be true and ����3 '�2 O <br /> correct. All provisions o(/a�vs and ord�nances goveming this type o(work will be completed <br /> whefher specified herein or not The c�ranting o(a perrmt does not resume to give aufhonty to <br /> ` vio(afe or cancel tho provisions of any other state or local law reguPting consfrucfion or the <br /> � peA,rmance of construction. That 1 am authorized by the on�ner of Ihis property to perfonn fhe <br /> � work/or which application is made�iid 1 comply�vith fhe State Contractors Law 18.27 RCW and <br /> �i 296.200W�C:'� � �% <br /> , / / <br /> -1 (�� ;�il�,� � - � �� <br /> " T- <br /> Signature Date <br /> � <br />