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ELECTRICAL PERMIT APPLICATION <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 ACCFPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> � ., i . . <br /> �, � i '� .�_ � �i � ' ��� � � <br /> � <br /> PRCJECT ADDRESS � <br /> '� . � — <br /> _ .` , � : �C'"'� ��c"; a �i,iC �tlo�� ! �ij-- `; :=_1� <br /> Owne� ' Mail Address City State/Zip Phone <br /> Tenant Mail Address City Slate2ip Phone <br /> Electrital Conlractor Mail Adtlress City State/Zip Phone <br /> State License Number Contract Price of Work <br /> l�l.?�, ' , _. , � �:i'-I'! <br /> i., �( ��,,.�� ��-1 ��.r ,��,� .� ��- '�ir, :�n �),-i.a;r� : <br /> Pmposed Use�of Building ' Contact Person (Plar�Review) <br /> Description ot Wurk to Be Done: I '� • ' �� �� � ' � . �-� r� i � ;�"i '�-� - � �" � .�� <br /> � <br /> � r �.. � , � , { . n�' 1�� ��J� _ I I� � � � <br /> � i �. 1 , 1 <br /> I - , '�r I�� � r� ,,, ,r Y"< <I i �� r rn-�- - <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 CO�E IS 3105 <br /> I hereby ceRi/y lhat I have read and examined this apolication and know the same to be true and <br /> conect. All provisions olfa�vs and ordinances goveming this type ol work will be completed <br /> whether speci6ed herem or not. The granting;,!a permd does not presume to give authonty to <br /> vielafe or cancel Ltie provisions of any other s(ate orlocal law regulafing construcfion or the <br /> peAormance ol construcLon. That I am authonzed by the owner of this propeRy fo peAorm the <br /> work(or�vhich application is mcae and/comply wifh fhe Slate Contractors Law 1827 RCW and <br /> 296.200 WAC. <br /> I ' <br /> S!gnaWre � �are <br /> I <br /> C ���il -��� � <br />