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ELECTRICAL PERMIT APPLlCATION <br /> CITY QF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICAT'ONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPiED <br /> �'JCi � Sr}+�N� J � L�'1 � <br /> PROJECT ADDRESS <br /> � S � <br /> � <br /> Owner Mail Address Cily Stale/Zip Phone <br /> Tenant Mail Address City Stale/Zip Phone II <br /> �cu ,,.� �/1,1�� �le� <br /> Electrical Coniraclor Mail Address City Stale2ip Phone <br /> V�CU �✓�iV4 '.�� InJ�� <br /> Stale License Number Contract Price o(Work <br /> � <br /> �2�5 , .(.«.,��, �. I — <br /> Proposed Use of Buildinc� Conlact Person (Plan Review) <br /> I,� I <br /> D�scriplion of Work to Be Done: i�,W Y l G'�� (/� t(�1✓1��, <br /> NOTE: WIRING IN PJON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� I hereGy certily that I have read and examined this application and know the same to be true an i <br /> conecL FlII provisions ollaws and ordinances governmg fh�s type ol woih will be completed <br /> whefher speaGed herein or noL The gran(ing o�a pennd does not resume fo give aufhority to <br /> viola(e or cancel the provisions o(any other state or local law reguPting construc(ion or the <br /> perfamance oI constnictior,. 1'hat!arn aufhorized 6y the owner ol this propen`y to peAorm the <br /> work Ior which application is made and I comply wifh fhe State Confractors Law 18.27 RCW anil <br /> 296.200 WAC. <br /> ;� .- <br /> �/ � <br /> �� '���-�_ �� � � ' °� � . ��j� <br /> SignaWre Date � — /J� � <br /> (� V � <br /> � <br />