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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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />�G,� � � � ..� �� � / — � �"� ! �� , � ir _ <br />_ f _ _ _ �; <br />PROJECT ADDRESS <br />-�7 �' I � r, <br />c.ii � '-�i� � . ,/ S. �7 7< �� <br />��1'��i�7F!" �� ��.� ��� ��� '�'��/,� ���% �i.�"�Q�t��.�� l—� � �.i��/-'y �. ..i�� l . L ri �' �i <br />Owner Mail Address City State/Zip Phone <br />�l,'(' � `' e.� ��C.`% �i ��ji �,;i� ��i i�'�'� �i �� ��i� ��1, r < %� `; ,� L�"` _ / t/')�- �`. ' �)%.�� �) <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor <br />State License Number <br />Proposed Use of Building <br />Mail Address <br />City <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Phone <br />, „ ,� � � r ,� i , ,� , , i� <br />Descri tion of Work to Be Done: 1--� �� � � � � �" ' %�' �/J ,'C��" � � '' �� �` ',<=�� " ����, �� <br />p ,�i�� r ,�1,� fo4� _ �7>- _ � �/ <br />� <br />`'! � . � � / I /j; _ jJ/�._.,' l �� i y i4 " `� / ; � i %� :� � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a perm�t does not presume to give authority to <br />violate or cancc1 fk�e provisions of any other state or local law regulating construcfion or the <br />performance of construction. Thaf I am authorized by the owner of this property to perform the <br />work for which applicafion is made and I comply with the State Contracfors Law 18.27 RCW and <br />296.200 WA�iI <br />� <br />��� �� j � , <br />� .. , � <br />/� i '� " � , <br />�_ � ,� , � � .� <br />, �. �> � �. ,. - L , <br />Signatur,e Date � <br />FEE <br />.= , <br />.� <br />