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ELECTRICAL PERMIT APPLICATIOlV <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 /> . , . " � r.. i ;, G� , <br /> PROJECT ADDRESS <br /> , <br /> Owner M1tail Address City State2ip Phone <br /> Tenznl Mail Address Cily State/Zip Phone <br /> � ,, _ t_ <br /> EleClrical COnlractor Mail AAdress Ciry StalelZip Phone <br /> Slate License Numbr,r Contr2ct Price af WorY. <br /> Proposed Use ol Building Contacl Person (Plan Review) <br /> Descriplion of Work lo�e Done: � �^ `�!-�-' ' � �-�j � :`�� ��tic' �� � '` � I'��� � - `��� <br /> tJOTE: WIRING IN NON-DVVELLINGS IS REQUIRED TO FEE <br /> B[ IN RACEWAYS, tv1C OR AC CABLE. <br /> i <br /> CITY OF EVERETT LOCAL SAIES TAX CODE;S A705 <br /> i I;ereby ceriify thaf 1 hove read und exarnined fhis appliwfion and know the same to bc true and <br /> ��rnecl. All pro�isions ollmvs and orcfoiances povernmg fhis(}�pe of noik�vill be complefed <br /> n liether specilied hemin or noL The granfinc�o/a pentut does nof rosurne to give autho�ity to <br /> , i�iolafe or cancel the P��visions o/any clher state or local la�v reguPting construction or fh,e <br /> pnrlormance ol consVuc6on. That 1 am aufho�ized by fhe o�vner o(fhis properiy fo peAorm fhe <br /> �rork lor which 2pplicalion is rnade and I cornply�rith fhe Sfafe Contracfors Law 18.27 RCW and � <br /> 796200 WAC. ;^ <br /> � /'Y ) <br /> /�-�__. � �_� <br /> / i �--� �-/� �.- � � " �U�-' � ��� <br /> Sicnalwe Dote <br />