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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 ACCEPTED FROM 8 AM TO 4 PM <br /> � � /, / <br /> G��1�0 ,/ ���X«� / <br /> PROJECT ADDRESS <br /> Ownef A4ail Address Ciry State2ip Phonc <br /> Tenanl Mail Address Cily Slale/Zip Phone <br /> Eleclrical CoNractor Atail nddress City 54�eiZip Phone <br /> Slale License Number Conlract Price of Work <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descnplion o(Work lo Be Done: l iL � (^A� ( S "-" �1�����n�.f.�W' �CL-' -i��� / <br /> � <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 3'-05 <br /> I hcreby certify Ihat I have read and examined this ap�dication and know fhe same fo be true and <br /> con�ect. All p��visions o/Imvs and o�dinances goveming th�s lype ol u�ork�vill be cornpleted <br /> �vhether specdied herein or not The granfing o/a pe�nut does nof resume lo give aufhonty fo <br /> violafe or cancel the uovisions oI any other state or iocal law reguPtin,q construc6on or the <br /> perlo�mance ol cons�ruction. That 1 am aulhorized by the o�rner e/Ihis property to perfom�U�e <br /> �vo�k lor which applicalion is made and I compty�rith fbe Stale Coniractors Law 18.27 RCW and <br /> 296.200 WAC. ,� � <br /> j '. <br /> � � v`- ` <br /> /� Sic�naWre Date <br /> �os�v-�Z� <br />