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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 a-- �-0 9 <br />425-257-881 D- FAX 425-257-8857 — www.everettwa.org �� q���16 <br />/ <br />APPLICATIONS ARE ACCEPTED FRUM 8 AM TO 4 PM <br />�Z�I� 20�'' �� �� <br />PROJECT ADDRESS <br />Ovmer J <br />Tenant <br />�',rn� �rve <br />Electncal Contractor <br />�5/�Jt/�/S'�Dlp �G1� <br />State License Number <br />Proposed Use o( Building <br />Descri;riiun of Work to Be Done: <br />Mail Address <br />MailAddress <br />=���- <br />Mail Address <br />�� <br />��� 5t , � <br />Cily <br />City <br />�- i�l S <br />Cily <br />State2ip <br />Stale2ip <br />Phone <br />Phone <br />'/si5/ Z� � �7� <br />�j'o b, � <br />Contrect Pnce of Work <br />Contad Person (Plan Review) <br />J <br />hOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br />B� IN RACEWAYS, MC OR AC CABLE. <br />�_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hemby ceRify fhaf I have read and examined Ihis applicafion and know tho same fo be frue and , _ v I� <br />oorrecL All pruviwons ollaws and ortlinances govemmg Ih�s type ol work will be completed .. _�—G �� <br />whether speafied heroin or n�L The yranting ol a pennd does nof presomQ to give authonty to �- �� ! L� <br />violate or cancel tha provisions olany other stafe or locallaw regulating consWction or Ihe <br />peAormance o/ conslruclior.. That 1 am au(honzed by fhe owner o/ fhis property fo peAorm fhe <br />work lor which application is made and 1 comply wifh fhe Sfafe Coniracfors Law 1827 RCW and <br />296200 WAC. <br />i' _ `.� ,� <br />c� Y , <br />