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ELECTRICAL PERMIT APPLICATION <br /> CITY nF EVERETT PERMIT �ERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-88 i 0 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CFEDIT CARDS ARE NOT ACCEPTED <br /> '°<- ' i <br /> ,�. --;,' _-,� ._ , L-� _ /G <br /> PROJECT ADDRESS <br /> /�- `.� <br /> Ownef Mail Address City Slate/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> ,/ �/�//� �� s'G/ <br /> ��-�iin1 i ' `iL4'y� r/f';..���� l7 �f/'� Sr:.�/i�,1C-� � //Y� ��lT-[./�.✓.7 �/Y%J �;ji�757�'- <br /> Electrical Contfactor Mail Address Ciry Stale/Zip l�����J Phone <br /> �/' �j Ji <br /> �,ii�///��� j /./nl�/ <br /> State License Number Contract Price of Work <br /> ��i ��--� <br /> f—�.'_,��£�iJ�.r'L ` � �/G�u.J..IS, <br /> Proposed Use of Building ` � Contact Person (Plan Review) <br /> Description of Work to Be Done: �����'''`��, �t/ '� ''-�• <br /> � <br /> NOTE: WIRfNG IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC GR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify tha[1 have read and examined this application and know the same to be true and <br /> correct All provisions o(laws and oidinances goveming this type o/work will be completed <br /> whether specil�ed herein or ncf. The granfing ol a permd does not presume to grve authonty to <br /> violate or cancel the provisions of any other state orloca/law regulating construcnon or the <br /> pedormance of consvuction. That 1 am authorized by the owner o(this propeRy to perform the /� <br /> work for which application is made and 1 ccmply with the Sfate Contractors Law 18.27 RCW and � I <br /> 296.200 WAC. . <br /> / i� � /1. <br /> i.. . '—� " �— '1. C l � 'U S I-���, <br /> Signature Date i�� <br /> � <br />