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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR S�(REET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-N�ww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � - • _ <br /> PROJECT ADDRESS <br /> . f �,- - ; � <br /> ... .. ., _ / �. ::_ __ _ _ � <br /> Owne� �' �MailAddress Ciry Stale2ip Phone <br /> Tenan� Mail Address Cily Stale/Zip Phone <br /> � �i. � y�: �' �( :�,�� . �l� ' � /=J - �/.r_�- �=i , —_ <br /> Eleclrical Conlractor hlail Address ity �� � Stale/Zip Phone <br /> Slate License Number CoNracl Prico of Work <br /> _ <br /> i . . <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> � � . � . .. - I -'� ���-� ` <br /> Oescriplion ot Work to 6o Done: — <br /> NOTE: WIRING IN NON-DWELLINGS IS REC�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABIE. <br /> CITY OF EVERETT LOCAI SALES TAX CCDE IS 3105 <br /> 1 hereby ceriil}�!:raf I hm�e re�d and ez�amired fhis ap/�lication and know Ihe sarne to be true end <br /> conrcL All provi;ions ollaws anA ordinances governmg this rype ol�rork will bo complefed <br /> �shether specilicd he�ein or noL The granfinc�o/a pennd does nof �resunte fo give aulhonty fo <br /> violafe u cancel the novisions ol arq�ofher stale or local latv regulafing construcfron or tha <br /> perlormance o/cons{iuction. Thaf 1 mn authorized b}�fhe o�rner u/Ihis property to perlonn(he <br /> work lor whic0 applicafion is mado and 1 cornply u-ilh the Sfate Cenlractors Laiv 18.27 RCW and I <br /> 296.200 WAC. <br /> � o _ � <br /> IOIII IID /D <br /> Signalure Dalo � <br />