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ELEC�'RICAL PERMIT APPLICATION <br /> CITY OF EVERETT F=EfeMiT 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 /> l :� l C' l��'Y' % �l l I <br /> ;� <br /> PROJECT ADDRESS <br /> ; ,5 <br /> � l,� j/����� <<r'��lf, <br /> Owner Mail Address Cily State/Zip Phone <br /> Tenanl Mail Address City StatelZip Phone <br /> �,�' <br /> i��I�%�/il `�' �%l�'I(��/7r,(%('I�17�(� `/�>/ �/';'l.r' Sr- �l�(:�P%% ���'( ����'�, <br /> EleCtriCal Conlfaclof ' Mail Address City State2ip Phone <br /> Stale License Number Contract Pr,ce ot Nbrk <br /> Proposed Use o(Building Conlacl Person (Plan Review) <br /> Descriplion of Work to Be Done: <br /> � y���;�°i c��,,;�c <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 cerfily fhat 1 have read and examined this application and knou-Ihe same to be true and <br /> conecl. All p�ovisions o/laws and oroinances 9overnmg Ihis lypc oI work will be completed <br /> �vhether specdied berein or noL The granting ol a permd does nof prosume to c�ive authoriry to <br /> violate or cancel the provisions ol any ofher sfafe or local la�v reoulating censfrucfion or the <br /> perlormance olconsfrucGon. That 1 am authorized by the owner o/fhis property fo perfomi the <br /> work for�vhich applicafion is rnade and 1 comply wilh the State Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> /� � ��l% � ��td <br /> - �.,� �%�,il� l ���� <br /> � � SignaWre Date <br />