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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROJECT ADDRESS <br /> ,r 1 , !t i ( �/ <- r'/Irn�. 'r ,1.�/ ✓ . �r i1' ti,_ , , <br /> .ti <br /> Owner Mail Address City Slate/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> '12o/f Z.1'7 ✓f 1- r 4 .r' f/ n. I e/ Z sSS_5-3y7 <br /> Electrical Contractor Mall Address City Statu'Zip Phone <br /> Stale License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: /c r, c . CL ( ll:, 7— <br /> NOTE: <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ce" IIt l have read and examined fhls application and know the same fo be true and <br /> correct. All provisions of laws end ordinances govemingg flrls type of work will be completed <br /> whether specl8ed herein or not. The grenting of a pemr7f does not presume fo give eufhodfy fo <br /> violate or cancel the provtslons of any other state or local law regulating consfrucflon or the <br /> performance of construction. That I am authodzed by fhe owner 01 this roperly fo perform the <br /> work for which application Is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br /> 6 _/ / <br />