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C� <br />• <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVEREI'1" P�RIVI11" �ERVICES <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 />,-� <br />�. <br />� `�l Z � (,� �.��.z��,r�� ,�,� <br />PROJECT ADDRESS <br />w��� � �J ��� 5 <br />Owner PJlail Address <br />Tenant <br />� � ��,� �rG �. � �l� Cl, <br />Mail Address <br />�, L �tv <br />� <br />City <br />City <br />Electrical Contractor Maii Address City <br />� ��v � � � �Z � � ��7 <br />State License Number <br />Proposed Use of Building <br />� ��v � <br />Square Footage (If residential new construction, remodel or addition) <br />Description of Work to Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />State/Zip <br />State/Zip <br />�>� ` ��D�' <br />Phone <br />Phone <br />wi�- ���ze-� fz5 s.��%��� <br />State/Zip Phone <br />! J`v �C, " � ✓ <br />Contract Price of Work <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify ihat I have read and examined fhis application and know fhe same to be true and <br />correct. All provisions of laws and ordinances govemm� th�s type of work will be completed <br />whether specified he�ein or not. The granting of a permit does not presume to give autl�onty to <br />violafe orcancel the provisions of any otherstate orlocal law regulating construction orthe <br />performance of construction.,'�Thahl am authorized by the owner of this property to perform fhe <br />work for whi h pllcation is�made.' and I comply wifh the State Contractors Law 98.27 RCW and <br />296.209-W� . � ; <br />� / I �` i i � � -' � <br />, ��,, � � �� � � <br />�%�� gnature ate <br />FEE <br />�_ 1r��C� �,)v � <br />. % � <br />�� <br />�,, � <br />���'� ✓ <br />� r l,�v�. <br />, ✓� <br />