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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 /> _, , ' � , � <br /> ,I _� � • 5 .���( ,��F�I l-� � .I , <br /> PROJECT ADDRESS �� � <br /> ; ,. <br /> Owne� Mail Address City Slale/Zip ^Iwre <br /> Tenanl Mail Address Cily State/Zip Phone <br /> Eleclrical Conlrac�or A1ail Address Cily Stale/Zip V�hone <br /> Stato License Number Contract Price of Work <br /> Proposed Use of Building ,--� Conlacl Person (Plan Review) <br /> DescriplionofWorkloE� Done: � f+ '// �% . � 1 � ,� �_ .. <br /> ; � r �����1�-'L�/ �� /l.�;� � �Lr ( � iti:.t/,�.( <br /> _ �CC>��C�i��- // Z � � <br /> ; <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 certi(y Ihaf I liave read ond exarnined fhis application and know fhe same fo be Vue and <br /> correcL All prov�sior,s ut��ws and ordinances goreming this fype ol work�rill be compfeted <br /> �thether specd;ed fr�reir.or noL The granfing of a pernut does nof resume to gn�e authority fo <br /> violate or cancel fhe provisions ol any other stafe or local la�!-reguPtinc�construc6on or the <br /> perfonnance o(construcfion. Thaf I am aufhonzed b}�the o�vner o/fhis property fo perfenn ihe <br /> work lor�vhich application is rnade and 1 cwnply�rith the Stafe Confractors Law ;H,27 RCW and <br /> 296.200 W.4C. <br /> SignaWre � Date <br /> E �����-��3 <br /> � <br />