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ELECTRICAL PERMIT ApPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREEI , FVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />i ' <br />�' � � - .�? 1.>—c <br />PROJECT ADDRESS <br />� � <br />Owner <br />nf1') l�� <br />Tenanl <br />. � � �� ' <br />Eleclrical Contractor <br />Slale License Number <br />% ��, � <br />Proposed Use ot B ildiny <br />o( Work. to �e Done: <br />� _ i � . _ <br />ppp;_ICATIONS ARE ACCEP7ED FROM 8 AM TO 4 PM <br />Mail Addross <br />M11ail Address <br />Mail Address <br />City, <br />Cily <br />State2ip <br />State/Zip <br />Slate/Zip <br />II � �f—�o <br />�/O// -� 2� <br />Contrect Price of Work <br />Conlacl Person (Plan Review) <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CAI3LE. <br />CITY OF EVEFETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceRily fhat 1 have read and exarnined this application and knew the same fo be true and <br />correcL All provisions o(la�vs and ordinances governmg this type o( work will be completed <br />whether spea6ed herein or noL The graminc� o( a pernut dces nof presume fo give authonty to <br />violate or cancel the provisions oI any other state er local law re�ulafing construction or fhe <br />per(onnance o(consVuction. That I am authorized by the owner ol this property to pedonn the <br />�vork Jor �vhich applicatien is made and 1 cornply �rith Ihe State Contractors Law 18.27 RGW and <br />��1 SignaWre � <br />FE�— <br />L <br />rnone <br />�•nonc <br />�lUil-Uz2 <br />nwuc <br />