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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SEi7VIC►cS <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - F,4X 425-257-8857—www.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> 33Z� ���� <br /> PROJECT ADDRESS <br /> ����� ys <br /> ���/ �� ��. ��x d��� .��r.�t� w,U y'�a�� <br /> Owner Mail Address City Stale2lp Phone <br /> Tenant DAail Addrere City State2ip Phone <br /> �� — <br /> E�ectrical Con!ractor Mail Address City � SWte21p Phone <br /> �SoO , dd <br /> State License Number Contract Price of Work <br /> Proposed Use of Duilding Contact Person (Plar�Review) <br /> Description of Work to Be Done: / ���'�( /v Ci G— � � �f�� '—' �GG �T�'"i/� _ <br /> I j N�D r,L_N� So'✓'I//r .-P� <br /> NOTE: WIRING IN NON-DWEL.LINGS 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 ceRify that I have read and examined this app/icafic�c.,d;:���..;P; same to be irue and <br /> correct. All provisions o(laws and ordinances governing this type oI work wil�he,co:npleted <br /> whether speci�ed herein or noL The granting of a permd does not presume to y:ve authonty to <br /> violate or cancel the provisions o(any other state orlocal law regulating construc'ion or tha <br /> pedormance of construchon. That I am authonzed by the owner of this property.o peAorm the <br /> work tor which applicalion is made and I comply wifh the State Contrac(ors Law 18.27 RCW and <br /> Zss.zoo wnc. <br /> J�C� ` 5 02-' o � � <br /> Signature Da �^/I� <br /> �� J <br />