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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 /�-���b 6 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM E �6 0�..a5y <br /> ��-� I � � �o�� a�2 <br /> PROJECT ADDRESS <br /> �] O � �����j��}� �c'�� (2.�`a � il-1�t L l� • �(, � <br /> Owner h11u1 Add •ss City State/Zip Phone <br /> N � �/�., <br /> Tenant Mail Address c�p- siata2ip pnone <br /> Eleclrical Conlraclor Mail Address City State/2ip Phone <br /> Stale Licensc Number Conlracl Price ol Work <br /> Proposed Usr.of Duildinp Conlacl Person (Plan Review) <br /> Descriplion o�Work lo De Done: ����-I��t:ij �va(i ��?-��.i I�U/J !/ 1 (�f�P C'� ���� <br /> t�..�p �i�.�r�f�c7rn S <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACFWAYS, MC OR AC C.4BLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cr.�tily thaf 1 havc rcad and examined this�pplir.afion nnd know fhe same fo be Gue and <br /> correct. All provisions o/la�vs and ordinances guvemin�Ihis fypa o/wo�k�rill be complefeA <br /> wlrelher spealieAhe�ein or noL 7he gianlinr�o�a pernul does nof vesurne to give aufhonty fo <br /> violafe or cancel fhe�vovisions ol any other state or/ocai la�v regul�ling consfrucfion or fhe <br /> peilom�ance ol cons ruction. That 1 mn authorized by the o�vner ol this property to pe�form Ihe <br /> �rork lor which applicafion is rnade and I con "!}��vilh fhe Sfafe Contractors Law 78.27 RCW and <br /> 29G.200 th'AC. <br /> i <br /> , ; r' � � G I' ll ��b <br /> Si9naWre / Da1e <br /> . / .�`� <br /> t��L' <br />