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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 /> � �`�`� �,_,.� y'� <br /> � ��°l D�. Y �;�,� �v��� s��c�� <br /> PROJECT ADDRESS <br /> ��e, �'.������ i.��.:��.� ��+��-� <br /> Owner Mail Address City State/Zip Phone <br /> /�. <br /> �..,� r�C�� ��`���.�,� ���.�.�� <br /> Tenant Mail Address City State/Zip Phone <br /> .-. �+ / <br /> �ro �" ��? �� � c' � .�;�� -6 A'J e�j'��'�t�7 <br /> EleCtl'ical ContraCtor Mail Address ity State/Zip Phone <br /> ti�,'��F..S\�l. C�� 1 .e��xs�"�-:= <br /> State License Number Co�ct Price of Work <br /> C�F��L��G..� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: {'tG�'� � d � 1�°�r� ������ �,7��' �S <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 /> .- �- <br /> I hereby certify thaf l have read and examined this application and know the same to be frue and ��; ��' � C_�l � <br /> correct. AI!provisions of laws and ordrnances governin�this fype of work will be complefed <br /> whether specified herein or not. The granting of a perm�f does not presume to give author�fy to <br /> violate or cance!fhe provisions of any other state or/oca/!aw regulafing construcfion or fhe <br /> performance of construction. Thaf 1 am authorized by the owner of this property to perform the <br /> work for which application is made and 1 comply with the Sfafe Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ----� �« � � <br /> Signature Date <br />