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ELECTRICAL P�ERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, [VERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> --� � . <br /> l' f �) �( �� � � � <br /> PROJECT ADDRESS <br /> r- <br /> �fZJ �$C�• �71�� <br /> _� , �- ;?. G9�<<�� � �� �_�� ,�1� ��, S�-��,�� s,r��� ��=�� <br /> (.)wner Mail Address City Slale/Zip Phone <br /> Tenant Mail Address Cily Stale/Zip Phone <br /> F'e:lrical Conlraclo� tdail Address Cny S�ale/Zip Phone <br /> Slale License Number Contrecl Price of Work <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriplion o(Work to Bc Dona: � ��%�%� `v�<J'..!"- <br />� MOTE: WIRING IN NON-DWEL'JNGS IS REQUIRED TO FEE <br /> B[ IN RACEWAYS, MC OR AC CABLE. <br /> CI'�Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certdy fhat 1 have read and examined fhis applicnfion and kno�v fhe same to be frue and <br /> conecl. All p:avisions ollaws and orAinances govemmg(his type o!�rork will bs canpleted <br /> whether specrlied herein or noL The granting o(a perrnd does no! resume to give aufhocty fo <br /> violafe or cancel lhe provisions o/any other sta(e or local law reguPting construc6on or the <br /> per(orrnance cl construcGon. Thaf I arn authoiized by fhe o�vner o.�fhis property to per/onn fhe <br /> work lor which applicafion is made and!conrpty with the Stafe Confractors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> �--- � / <br /> \-- <br /> --- L� �� �K� (-/���/� �v <br /> Signa ur� Date <br /> � L�'G� � �� <br />