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ELECTRICAL �ERMIT 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 /> I APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � �, <br /> I r II �7 �v� _ L"\'/Cr7`1 l%�^� <br /> PRGJECT ADDRESS <br /> � - <br /> I;,X7,, � i�: , i:�;; ia^�Y7 /,'v,. r�r��_r->7 ��,li� la �- ' <br /> � �, �� �� (��.-sk�� ��_ <br /> Owner Mail Address City State/Zip Phone <br /> � Ir <br /> Tenanl i Mail Address City Slale2ip Phone <br /> ;If, <br /> Eleclrical Contracto� Mail Address Ciry Stale.2ip Phone <br /> � <br /> ti�/, <br /> State License Number Gontract Price of Work <br /> 1 <br /> I,f::�I�F f��._F <br /> Proposed Use of Buildinc� Contact Person (Plan Review) <br /> Descriplion of Work lo Be Done: k'!;�,,�� � r�� r''i���< <br /> NOTE: WIRING !N NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABL[. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cer7ily fhaf 1 have read and examined this applicafion and know fhe same to be true and <br /> correcL All provisions ollaws and ordinances govemmg(his type ol�vork will Ge completed <br /> �rhether specdied herein or noL Tbe grantin�at a pernut does not presume to give authority to <br /> violate or cancel the provisions olany ether state orlocal/a�v regula(ing conslructicn or Il�e <br /> perlurmance o(consf�uction. That I am authonzed by the owner o/this property fo peAorm the <br /> �sork lor�yhich applicalion is made and I comply wifh fhe Sfate Coniractors Law 1827 RCW and <br /> 29&200 N�AC. � <br /> i <br /> � . � i <br /> SiUnaWre ��� Date <br /> �C�/ - S�c <br />