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1 <br /> ELECTRICAL PERMIT APPLICAYION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 3 ���7 "dg <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org �. p9� 3,..0 g� <br /> APPII:ATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �`���� �'a�C .0 �,� \�o lL,�.� <br /> PROJECTADDRESS <br /> �,l�� 1 C�'V� � �rl ��1�� ��I 1 c�D �lUl'EI�J ��,2�LI �U-P,t`(� <br /> Owner �Mail Adtlress r City State/Zip Phone <br /> Tenant Ma1lAddress City Slate2ip !'hone <br /> � � �° � c �R(���n��f� r �.� a11iSC �.1�" ��t� �,i���o�1 �1 i�ik.t�fr�� <br /> Electn al Co iractor hlail Atldress Cily StatelZip ��Ptn�� " <br /> (.� <br /> ��� l .I 1�� ('1 ►'1'1 Z.���.�� <br /> � Stale Lic nse m er Contracl Price of Work [j �'—"�I-�� /I <br /> . I n � L <br /> ��(�i l`-,� "L <br /> Pr pose USe of Building Contad Person (Plan Review) <br /> Description of Work to Be Done' ��— S�� <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 CODE IS 3105 <br /> I hereby certily thaf I have read and oramined this applrcation and know tho same fo bo truo and <br /> r,orrecf All provisions ol laws anA ordinances govemmg fhis type o/work wi0 he comp'o(ed <br /> u�hether speci6eAherein or noL The granting o/a permd does nof resume to pive au(honty to <br /> violate or cancel tho provisions ol<any ofher state or/ocal la�v reguPhng consf�iicuon�•(he <br /> peAonnanr.e of conshuction. That I am aulhonzed by(he owner ol this propurty to peAorm fhe <br /> work lor which applica(ion is made and I cornpty with Ure Sfafe Contractors Law 7827 RCW and <br /> 296.200 WAC. <br /> SignaWre Date <br /> EUGo.3 U&-I <br />