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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C[DAR STREET, EVERETT, WA 98201 <br /> 425-257-881C - FAX425-257-88�.' -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED I <br /> , <br /> '��j�.lr'�_ � � /� �,_� <br /> PROJECT ADDRESS <br /> , <br /> '� ,'��" �. : _ <br /> Owner � Idaii Addrnss City State/Zip Phone <br /> Tenant A1ail Address City SlatelZip Phone <br /> I <br /> � ��, � , ���.� � C , �; l � <br /> Electrical Contractor Mail Address Cily State/Zip Phone <br /> State License Number Conlract Pnce of Work <br /> �—� �, <br /> Proposed Use of f3uilding Contact Person (Plan Rev;ew) <br /> Description of Work to Be Done: -��c-� � ��,�;` <br /> NOTE: �VIRING IN NON-DWFLLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerfify that 1 have read and examinad lhis applicafion and knew(he same to be true and <br /> currecL All provisions ollaws and ordinances govem;ng th�s type of�t�ork�vdl be completed <br /> whefher specihed herein or not. The granting o/a permd does no(presume to give authonty to <br /> vielate or cancel the prcvisions nlany other state orlocal la�v regulaiing construcLon or the <br /> pe�fermance d constructiun. That 1 am authenzed by the owner uf th�s prcperty to perlcrm the <br /> wak lor which application is made and I c�mply�vdh ;i�e State Contrac;ors La�v 18.27 RCW and <br /> 296200 WAC. <br /> �,, � <br /> �'i,�'.� - � '� <br /> S�cn�wrc Date � <br /> � <br /> i� <br /> L •) '� <br />