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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 /> �'��� 1 �)'I�.P�'�ll�i�,� ,P11.�., /��%� � <br /> PROJECT ADDRESS <br /> ��?�"- l/o- 9,,��F.� <br /> � � `� <br /> � 1- ,C�,�f�/�,�. ����.� f �"l� /9�oi �ld'-` A�c c�� �a�,��'a : ��,.,,� 9,Po3� <br /> Owner h9ailAddiess Cily Stale2ip Phone <br /> �'enant Mail Address City State2ip Phone <br /> J���iCi�.�c� �i`� /�.� �/..c /�$Dy, 9)�1"'-'�/�i�E �J ���rio� /t /r�A ��oa?G -�..�9�J�.7•Ji.✓ <br /> Elec�ricalContr clor MailAddress Cily State/Zip Phone <br /> �/>C�.(�.�n�t�iD7�?lo _�C}'�°' <br /> State License Number Contract Price of Work <br /> Proposed Usc o(Building Contacl Person (Plan Review) <br /> Description of Work�o Be Done: � ,'"� ���f'i�' <br /> NOTE: WIRING IIJ NON-DWELLINGS IS REQU;RED TO FEE <br /> i BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that I have read and examined this application and know Ihe same fo be frue and <br /> correcL All provisions ollaws and ordinances govermnn this type ol work will 6e completed <br /> whether spea�ed herain or noL Tl�e granting ol a pernid does not presume to give authonty fo <br /> vioiate or cancel fhe provisions o/any ofher state or local law regulafing consWction or the <br /> per/ormance o/consfruction. That 1 am aulhonzed by fhe owner o/lh�s propeRy to perinmi the <br /> work for which application is nrade and 1 comply wifh fhe Slafe Confractors Law 1827 RCW and <br /> 296.200 IM1�AC. <br /> � � C ' //� / <br /> i /(J '����� <br /> SlgnaWre Date <br /> �. GSlv -G7L �JO� 7� <br />