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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 96201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> . ,l/���i' 1.� rfi�r ' � f� ,��Y_ <br /> PROJECT ADDRESS <br /> �(:zs <br /> �cc� i�1c�<<��, I�(�� �,��-1 �ti�rQ flve ��'��re�� ��.�a . �b:�C�l �sc � `i�� <br /> Owne� Mail Address Ciry � Slale/Zip Phone <br /> Tenan� Mail Address Cily StatelZip Phone <br /> �'CC �/ll'I <br /> Eleclrical Conlractor hlail Address City StateiZip Phone <br /> Stale License Number Conlrecl Price of Work <br /> Proposed Use ol Building Conlact Person (Plan Review) <br /> Description of W ork to Bo Done: � c���' / / / �t; ( / ( / l ( � <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 ceriil}�fhaf I have reaAand examined fhis applicafion and know fhe same lo be frue and <br /> correcL All prav�sions ol l.aws and ordinances c�overnmc�this fype o/woik�vill be complefed <br /> whefher speciGed herein or noi. The granling o!a pernut does nof p�esume to give aulhonty(o <br /> violafe or cnncel the provisions ol any othe�sfafe or local lau�regulating consirucfion or fhe <br /> peHoimance oI cons6uchon. Thaf I am authorized b��the owner o!this property to perlonn Ihe <br /> work lor ivh,ich applicafion is rnade and I compl}�wilh fhe Sfafe Coniracters Law 18.27 RCW and <br /> 296.200 WAC. <br /> C - ,, (,�L(. '> ) " /�_ ( C�� ,�� ' �—� � � . �� <br /> ,Signature Date -� h ) <br /> L' <br />