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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-fl810 - FAX 425-257-8857 —www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBiT 8 CREDIT CAR�S ARE NOT ACCEPTED <br /> ;' �/ ,� .�' C',lr_ r : �� Y':1%,, ✓r� l.,r� <br /> PROJECT AD�RESS � <br /> �r�� �� � <br /> Owner � ` 61ai1 Address Ciry State.2ip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> /l� 1i' %y /"= .C% ' <br /> EleCtriCal Contraclor M1tail Address City Statc2ip Phone <br /> State License Number Contract Price ot VJork <br /> Proposed Use of Buildin�, Contact Person (Plan Review) <br /> Description of Work lo �e Done: G� •r,/r�.i �r��.'�-�- <br /> NOTE: WIRING IN NON-DWEL�_INGS 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 certify that 1 have read and examined fhis application and knew the same to be We and <br /> cerrecf. All provisions ol laws and erdinances govermng fhis type o/werk will be completed <br /> �vhether specilied herein or ncL The qranting o/a permd does not presume to give authonty to <br /> violate or cancel the provisions o(any ofher state or local law regulating constructicn or the <br /> peNormarce el construction. That 1 am authonzed by the o�vner o(this preperty to pe�fo;m the <br /> wo�k lor which application is made and I comply with the Sfa[e Contractcrs Law t8.27 RCW and <br /> 296.200 WAC. <br /> �f�/�' .� <br /> ffignawre ' /� / Dat� � <br /> LUIJ - �Sj <br />