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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVER�TT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-25;-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ��' �:_ ��� C � /_�/� .� <br /> PROJECT ADDRES5 <br /> -- / !r r i ��. <br /> Owner Mail Adtlress City State2ip Pnone <br /> Tenant Mai�Address City State2ip Phone <br /> � i <br /> � <br /> —J Gi� � �J ,- �_ l '"1 ��� <br /> EleClrical Conlractor MailAdaress Ciry State!Zip Phone <br /> Stale License Numoer Conlract Pnce of'Nork <br /> �- <br /> � >� j� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Dane: � �� -�� I <br /> NOTE: WIRING IN NON-DWELLINGS 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 he�eby ceRrfy fhaf I have read and examineo this appiication and kno�v the same to be true and <br /> ce�rect. All provisions ollaws and ordinances govemino this type e/werk �vill be completed <br /> whether specihed herein or noL The granting of a permit dces not presume to give authonty fo <br /> violafe or cancel the provisions olany other sfate orlocal ia�r reyula(ing consfruction or the <br /> peAormance ol cons�ruc;ion. Thaf I am authenzed by the owner o(lhis property to pe�form the <br /> �verk for which application is made and 1 cemply wdh fhe State Contractors Law 18.27 RC W and <br /> 296.200 WAC. <br /> u,� � y� j��-/. <br /> Signawre Date <br />