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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32U0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everetriva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CF�DIT CARDS ARE NOT ACCEPTED <br /> � y�' Y ��r � �,-� ,,-Y; _ �� �� �` j /'� , <br /> PROJECT ADDRES � <br /> ./` ^-C �-� i- r �✓` /"���r'/o/�/.• r _:. <br /> Owne� Mail Address Ciry StaM_'Zip Phone <br /> Tenanl Mail Address City State/Zip Phone <br /> /✓� r'7��� . n ��-, �}" It�t.�,7'�-i � _L n . <br /> Electrical Conlractor Mail Address City State.2ip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Cont�ct Person (P�an Review) <br /> Description �f Work to Be Done: %����--'� /��i ir-� �'��^ r- <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 /> !hereby certily that I have read and examineC this applicatior and know fhe same to be true and <br /> correct. All provisions ollaws and ordinances goveming;his type ol�vork will be completed <br /> whe;her specdied herein or nc!. The granfing of a permd does notp resume to gi�-e aulhority to <br /> v�olafe or cancel Uie provisions elany other state cr local law regulatirg construction or the <br /> peAormance o/cnnsfruchon. 7hat I am authonzed by the owner oI th�s propeny to peAorm the <br /> �vcrk!or�vhich application is made and/comply wifh the Sfafe Contractors Law 18.27 RCW and <br /> 296.200 Ih�AC. <br /> �Z�c�'��_/� /v/w'�'/-, L, <br /> igna'ure � Oate 7- <br /> �(I � - 1�3 <br />