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ELECTRICAL PERMIT APPLICATION <br /> CITY OF �VERETT PERMIT SERVICES <br /> 3200 CED�1R STREET, EVERETT, WA 98201 � �• �,_� <br /> 425-2�7-8810 - FAX 425-257-8857 —www.everettwa.org � ` <br /> APPLICATIONS ARE ACCEPTED FROM 8 Atd TO 4 PM �- �� ?�� r �l J <br /> , <br /> < ,- `� • �; <br /> � <br /> PROJECT ADDRESS <br /> � . � � � _ .} � i <br /> Owner Muil Address City Stale/Zip Phone <br /> �i� i <br /> Tenanl Mail Address Ci1y Slale/Zip Phone <br /> �: <br /> [IeGrical Ce�itractor Nail Addmss Cily Stale/Zip Phone <br /> State License Number Contracl Price o(Work <br /> l. �� . <br /> . l,' ( . l A� � <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriplion o(V�brk lo Be Done: : � ' <br /> NOTE: WIRING IN NON-DWELLINGS IS REI�UIRED TO FEE <br /> � <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hr.roby catif}�that 1 have read and exeunined this application and kno�r the same to be Vue and � <br /> co�rect. All provisions o/la�vs mid ordinances govemmg th�s lype o��vork�vill be completed <br /> �rhether specilmd herein or�,oL The granting ol a permrt does not preswne fo give authonfy fo ��' <br /> violate or cancel the provisions o/any ofher sfate orlocal la�v regulating consfruc6on or the ^ i , <br /> periomiance o�consf�uction. Thaf 1 am aufhonzed by the o�vner of this property fo peAomi fhe <br /> work lor�vhich applicafion is made and 1 comply uifh the State Contractors Law 18.27 RCW and �I <br /> 29G.200 WAC. <br /> _ <br /> .� : <br /> Sic�naWre Date <br />