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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVFRETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—v�nvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ys3Z St�. n, ; = <br /> PROJECT ADDRESS <br /> 2 �> > <br /> Owner tilail P.ddress City State/Zip Phone <br /> 7enant Mail Address City State2ip Phone <br /> �G�l . N ���1� ( � �c C <br /> Electrical Conlractor M❑��Address City State�Zip Phone <br /> I�C'�.i . n N t�i��t �yl `� <br /> State License Number Conlract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> �- <br /> Description of Work to Be Done: _��� �� �t <br /> — i <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FrE ' <br /> BE IN RACEWAYS, MC OR AC CABLE. I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I' <br /> I hereby certily thaf!have raad and examined Ihis application snd know fhe same to be true and <br /> correct. All provisions ollaws and ordinances goveming fhis type o/work wil!be completed <br /> whether specified herein or noL The granting oI a permrt does not resume to give authority to <br /> viclate or cancel the provisrons ol any olhe�state o�loca/law�eguPting construction or the <br /> perrormance o(consfruchon. That 1 am authorized by the owner o(this property to peAorm the <br /> work lor which applica6on is made and 1 compty�vifh ihe State Contractors Law 18.27 RCW and I <br /> 296.200 WAC. <br /> �-�'-� ���� �' � 3 '� `-'� �� <br /> Signature Date <br /> G p,{o� `113 <br />