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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 6 ��3�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 [ 0 BOfJ���� <br /> 425-257-8810 - FAX 425-257-8857 -www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> , <br /> •='�_�L �. � . � , . ��. I.� i.�, � �"�(� <br /> PROJECT ADDRESS � <br /> �— - <br /> � ,e ,• � , � � � , ,, ,�� <br /> OwnEr Mail Address Ciry Slate/Zip Phone <br /> Tenant Mail Address Ciry Slate2ip Phone � <br /> i - � <br /> `c � j .. y �.J � %ie_'. - hli <br /> r >� fTTI. � \�Jo •�'n l l I 'i=� !i(`.v' <br /> Elec�rical Contractor Mail Adaress Ciry State2ip Pnone <br /> { � C�_ <br /> < <br /> , ` '.._ . �.,_'� �_� � <br /> t �..� i' �'_ <br /> Stale License Number Conlracl Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descnpiwn of Work[o Be �one �_� �'�- �� - <br /> . � r� �- ,,i. `��...'ii � � G/C�-.,C� 1.1,_a... <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 /> i hereby certdy thal I have read and examined th�s applicahon and know(he same fo be fine and <br /> co��r,ct All provisions ollaws and ordinances govermng fhis type ol work will bo complefed <br /> whethoi specdied herein or nol The granhng ol a permd does not presume to givo authonty fo <br /> vrolato or cancel the piovisions o!any othe�sfato o;local law regula!ing const�ucfion or fhe <br /> pedo�mance of r.onstruction Tha�I am.athoriled Gy fhe owner ol this property tn pedorm fi�e <br /> work lor which app6cafion is made and I comply�vith the Stafe Contracto�s Law 19 27 RCW and <br /> 296 200 WAC. - <br /> ;-- / <br /> - i . , ,!�.�. <br /> _,./,� ' i . <br /> � ignal r Oate <br /> ��,��� <br /> �,�� 1 <br />