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, ELECTRICAL PERMIT APPLICATIO�i <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 /> APPLICi�TIONS ARE ACCEPTED FROM 8 AM TO 4 PNI <br /> � <br /> � .��� , �-�� '���.�� \}�P1`�\�� <br /> PROJECT ADDRESS <br /> ���� � <br /> � 1 \�� p,�,' .�' .�Q'�� z3l- <br /> � 1�.'�\ ��4��\���1` ���'.`�l��`�.'\ ��,�,'��,��.Q �� �"s--�� 3 l�� <br /> Owner G7ail Address Cily Slate2ip Phone <br /> V \� <br /> Tenant Mail Address Cily Siate2ip Phone <br /> EleCtriCal ConlraC�or M11ail Address Cily State/Zip Phone I <br /> I <br /> Stat� License Number Conlract Price o�Work <br /> ���� ,� <br /> Proposed Use of Buildin9 Contact Person (Plan Review) <br /> D�scription of N'ork lo Bc Done: ���'�\ ��"\�Q� �� �` � ��d C—U" ` <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �i qTY OF EVERETT LOCAL SALES TAX CODE IS 3105 1 <br /> I 1 herehy certily Ihat I have�ead and examined this application and know fhe same fo be frue and E p�l �(;" �'� ��\ <br /> correct. All provisions o/laws and ordinances governin�this t ype ol work�ti�ill Ge cornplefed <br /> whether specrfied herein or not. The granting o/a pernuf does not presume to give authonry to <br /> violate or cancel the p�ovisions olany other state or local law regulafing construcfion or the <br /> IpeAomiance ol construction. That I am authorized by th�o�vner ol fhis properly to pe�Iom�the <br /> work lor which applicafion is made and I comply with the State Contracfors Law 1827 RCW and <br /> �J6.200 WAC. <br /> �//,�,i/. . `=.�-,^ �� ' ! 1 I; ,`� ,�i C� �� <br /> ����i � i <br /> � Signawre � � � Uate <br />