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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEUAR STREET, EVERETT, WA 98201 ��o8-O�j <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org �����/D(� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TG 4 PM <br /> n � <br /> I ;��c-=�,�� ��j ��"' i=�L�r' �, =. <br /> � <br /> PROJECT ADDRESS <br /> ��- i � � <br /> � �� <br /> 7 -� <br /> � �.)U� ��i� ._� C _, � l7� �,�� C,��,' ��jL--i.;�L�'-1 <br /> Owner Mail Address City State/Zip Phone <br /> Tenanl R1ail Address City Slate/Zip Phonc <br /> �(,�i ILUI.����! <br /> ' S <br /> ��, (h�li c�uv�� � c�� ��� �% C� I �� Nr 1�h,��l �1� i,!I� �J�G;��� <br /> EleClfiCal ConlraClor M11ai Address City � Stalc/Zip Phone <br /> Slale License Number Conlracl Price o(Worh <br /> 1 , <br /> �� (���;c <br /> Proposed Use o(Building Conlact Person (Plan Review) <br /> Description of Work l0 6e Done: <br /> NOTE: W IRING IN NOtJ-DW ELLINGS IS REQUIRED TO F[E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br />� <br /> CITY Of EVERETT LOCAL SALES TAX CODE IS 3105 I <br /> 1 hereby cerlily that 1 have read and exnrnined this ap�lication and kno�v lhe sanie to be true and ��5� 2- ��V� <br />� correcL All provisions o(laws and ordinmices g�vernirio this type o/work wil!be wmplet�d <br /> whefher specilied herein or noL The granfing o/a perrn"rt does not presume to give authonty fo <br /> violate or cance/the provisions ol an}�other state o�loca!law regu/afing construction or fhe <br /> perlormance o/construction. That 1 am authoiized by the o�rner of this property fo pe ;omi fhe <br /> �vork(or�vhic!i application is rnada and 1 comply nith the Sfafe Contractors La�v 18.2%RCl1�and <br /> 296.200 4l�AC. <br /> � ��� ���i� (���, � � � <br /> 1Signalure �ate ' <br />