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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 /> :ia� ��<k�s �.���. �� v.; A <br /> PROJECT ADDRESS <br /> I , r�'r :I ���� ,�� . 1 .24� 7 /ll; :! /• `-,,, ,V f�<-r L����„c��j�,! W}1 %f�'2G y2S 7Yj-5�4Y <br /> Owner Mail Address City StalefZip Phone <br /> Tenanl �dail Addiess Cily Slale/Zip Fhone <br /> [leclrical ConlraClor ldail Atldress Ciry State/Zip Phone <br /> State License Number Contred Price of Worh, <br /> ��s��4,�-I��r', � <br /> Proposed Use of�uilding Contact Person (Plan Reviewj <br /> Descriplion of Work to De Done: C hv o�. s=,�,r:� .> ��• � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, h1C OR AC CP.BLE. <br /> � CITY OF EVERETT LOCAL SALES TAR CODE IS 3105 I <br /> 1 here6y ceriily fhaf I have read and examined Ihis application and kno�v Ihe same fo be Vue and <br /> correct All provisiuns ollaws anA ordinances govermng this fype oI work �rill be cornp/efed <br /> wl;efher spealicd herein or nof. i he granting ol a permd does nof presume fo give aufhonty fo <br /> ��iolate or cancel fhe provisions o/any ofher state or loca/law regulafing consfruchon or fhe <br /> perforrnance o/construction. Thaf I am authorized by fhe o�rner ol this property fo perform the <br /> work lor which applicatio�is made and I comply ivifh the 5!ale Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � ! ��(1 _;�Zf.�-4 c� <br /> _' �\ � � 1 Ci f <br /> S�gnature � Date <br /> � <br /> � .`.:� ���� � l�� <br /> � <br />