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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 I' O 4 'G�J <br /> C D��l- O!O <br /> "��S lE'��i -��-�- �-- C�V-'I ✓� . <br /> PROJECT ADDRESS <br /> S[�� ����_c� nF�r�-( 12' `�� <br /> Otvne� Mail Address Cily Stale/Zip Phone <br /> Tenan� Mail Address City Stale/Zip Phone <br /> y L�� <br /> �' ; =���,.�r ��2 �oCr�. �= t"v�u�=_rt c.,,Vt `id2�� ��o S3�G <br /> Electrical Conlrector Mail Address City State2ip Phone <br /> .Q� <br /> ��t�� i=i �� _ �7 � � k- (' �a c�o � <br /> S at te License Number Cuntract Price of Work <br /> Proposed Uc.,of C3uilding Conlact Person (Plan Review) <br /> Description e(V�brk to Be Done: (��(!��— %�` Z���S� l O��v�1 '"`��-(��—�- <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 cerii/y thaf 1 have�ead and examined this applicafion and know the sam�to be frue and <br /> correct. All provisions ollaws and ordinances goveming this type olwork�till be �omplefed <br /> �vhefher specilied herein or noL The granfing o(a pe.�md does not presume fo gi��e authonf}�to <br /> violate or cancel ihe provisions ol any ofher stafe or local la�v regu/ating constructicn or the <br /> peAormance ol construction. Thaf I am authorized by the owner o/fhis property to per(orm the <br /> work lor�vhich applia�tion is made and 1 comply�ti�ifh the Sfate Confractors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> ���=r����— -- � —U <br /> Signat re �atc � <br /> r�[/.�C) <br /> � c cs o� -ctv <br />