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ELECTRICAL PERMIT APFLICATION <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 0 AM TO 4 PM <br /> �/.'' i /`�) �. '7 , ;��j,� /'� l__ /�/ t/�� <br /> � <br /> PROJECT ADDRESS <br /> �. <br /> �\ <br /> 1Jt�1��%�.���,. <br /> Owner � � Mail Address City State2ip Phone <br /> Tenanl 1�.7aii Address City Slate/Zip Phone <br /> �.�/ X iL�rLL-�� _-' <br /> Electrical Contreclor lda�l Address City Stale/Zip Fhune <br /> Slale License Number Conlracl Price of Work <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Doscriplion ol Work to De Done: �i � � �.(�'-� �����- <br /> J t9 <br /> _ /�///�"� �� .�{��tt -� , <br /> NOTE: WIRING IN NON-DW[LLIN6S 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 cerfily fhal l have read and exnmined Ihis applicnfion and knorv the same fo be lrue and <br /> ccrrect. All provisions o(la�rs and ordinances govermug th�s iype ol�+ork will be cornplefed <br /> whefher specr6ed herein or noL The granfing o!a pernuf does not msume fo give aufhonfy fo <br /> violate or cancel thc provisions ol any ofher sfate or lor,al law reguPfing conshuchon or the <br /> perlormance ol consfrucfion. Thaf I arn authonzed by fhe o�vner o/this property to perform fhe <br /> work lor which applicafion is made and I comply�vifh the State Contractors La�v 18.27 RCIM1�and <br /> 296.200 WAC. <br /> I % --,.. r <br /> - ; i�' �� �������� � <br /> / <br /> � Siynature � ' Date ! <br /> ��f01� '�J� <br />