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ELEGTRiCAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8L10 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS AF2E ACCEPTED FROM i3 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />I�,�2� �,;.. ; _.� <br />PROJECT ADURESS <br />�I c� c � /� ) �. r « .,.� c'. j C,'; , , ci`t �- ; :�'(' �-�.`�-( .: �'' Cx; � L�, Z � _St_� C _ ir,C(� , <br />OWner Mail Address City Slate2ip Phone <br />Tenant <br />Mail AdJress <br />City <br />State/Zip <br />I�UTit <br />�, -,<-fi=- - �lt-'iG�� ���Z'�'� Ac�c�._,C' �-. E�iu�<��Cfi t.�`h`=iS�?c� �-l?S-�`it: %L <br />ElectricalContraclor MailAddress Ci1y Stale/Zip Phone <br />PREs�`c� �,�:�_>�-�, <br />Stale Li�ense Number <br />�> <br />Propose� Use e( Buildlnp <br />Descriptlon of l�Vur4, ta i3e Don�: __ �;.-_\. .��, �- C�, <br />NOTE: W IRING IN NON-DWELLINGS IS RECrUIRED TG <br />BE IN RACEWAYS, A1C OR AC CAE3LE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />F l6cn c< <br />Conlract Price of Work <br />Contoct Person (Plan Review) <br />I hereby certily that I have read and examined this applicafion and know fhe same fo be true and <br />correcL All provisions olla�vs and ordinances 9ovenung fhis type o! �vo�k �vill be completed <br />�vhether spea6ed herein or noL The granfing of a perrnd does nof �esume fe give aufhorit}� to <br />violate or cancel the provisions o�any ofher state or local law reguPting consvuc6on or the <br />perlormance o/consfiur,tion. Thal I am aufhorized by the ownero(this property fo perform Ihe <br />work la which application is made and I comply with tha Stafe Coniracto�s Law 18.27 RCW and <br />296.200 WAC. <br />`7�-�., �s, cL� � <br />-�G� <br />FEE <br />,-r.�C`j C >/ <br />