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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 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBiT & CREDIT CARDS F�RE NOT ACCEPTED <br /> t��•j- c� ��S-Ge. 5 t�' �: S �= <br /> PROJECT ADDRESS <br /> � � \�� <br /> Owner �dail Address City State/7ip Phone <br /> Tenanl Mail Address Ciry Stale/Zip Phone <br /> )/,z�;�� ►�l,l�r � I« <br /> Elec�rical Con�raclor Mail Address City Stale/Zip Phone <br /> Stale License Number CoNract Price of Work <br /> Proposed Use of Building Cantact Person (Plan Review) <br /> Descriplion of Work to Be Dane: 5 ���-- _ _ <br /> i <br /> NQTE: W IRING IN NON-DbNELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> 1 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fBat 1 have read and examined fhis applicatiai and Ano�v fhe same fo be tnie and <br /> correcf. All piovisions o(laws and ordinances governmg Uus type ol�vork n�ill be completed <br /> whether speci6ed herein or not The grantin�ol a pernuf does no( �esume fo give authority to <br /> I�I violate or cancel fhe provisions o(any other sfate orlocal/a�v ie�uPting construction or the <br /> performance oI construc6on. That I am authorized by(he owner of this property to perform fhe <br /> �vork!or which applicafion is made and I comply with fhe Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � <br /> _�///�//�/J � � J � <br /> L� I �S+_�" . li� ` a� � �'�J I <br /> i n re Date <br /> L .__ " �{ ` I � � <br /> �� �� <br />