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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEUAR 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 /> l �/S / � S � <br /> PROJECT ADDRESS <br /> �CC.I Y�. n-P .� <br /> Owne� MailAddross Cily Stale2ip Phone <br /> Tenant Moil Address Ciry Slate2ip Phono <br /> �i���-e,!__, <br /> Elecirical ConUaclor Mail Address Cily State2ip Phone <br /> State Ucenso Number Conlracl Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Doscriplion of Work lo�o Donc: �,/{ � �" [/([/�� <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 ceriity(huf I have read and examined fhis application and knotv fhe sarne fo be Irue and <br /> correcL All provisions ofla�rs and orJinances goveming th�s type o(u•odc will bo complefed <br /> ivhether speaficd herein or noL The�ronling o(a pernuf does nof pr�sume fo give aufl�onty fo <br /> violafe or cancel fho provisions olany ofher sfate or local la�v regulating construction or the <br /> perlommnce p!constniction. Thot 1 am a�dhorized by the owner o/fhis property fo poAomi tho <br /> wo�k Ior�rhi h application!s made and I cwnpty with the Sfafe Confracfors Law 18.27 RCW and � <br /> 29G.200 W C. , <br /> ( 2 <br /> �'-L� OC�- ��� o - <br /> // / � <br /> — b ��i i ' '�6 ��/� - �� <br /> -5�0���� Date <br />