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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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />� <br />�.�Q� ��1S1� � iA iCILJ� <br />Pf20JECT ADDRESS \ <br />�J <br />Owner <br />Tenant <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />Mail Address <br />State License Number <br />�� A� C 1�C� II�\ ���Z_ <br />Proposed Us 8uilding <br />Description of Work to Be Done: <br />��� �'V..��� C r��f1S�z'��c� : c� � <br />Ciry <br />City <br />Ciry <br />�-t:� '�`1�� <br />Stale2lp <br />State2ip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Phone <br />Phone <br />Phone <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certi(y that I have read and examined this applicafion and know the same to 6e true and <br />correct. All provisions ol/aws and ordinances goveminq this type o/ work will be completed <br />whether specified herein or not. The granting o/ a permit does nof presume to give authonty to <br />violate or cancel fhe provisions o( any other state or local law regulating construction or the <br />per/ormance o! construchon. That 1 am authorized 6y fhe owner o( this propeRy to peAorm the <br />work tor which application is made and I comp/y with the Sfafe Contractors Law 18.27 RCW and <br />296.200 WAC. <br />�-- _ J <br />3natdre / <br />/ <br />L. //- /..t -G `-i <br />�oy il-Gi I <br />FEE <br />