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• <br />� <br />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 />< <- <br />� �'� \ "�1 "_1 � 1 -�. � ,- .. , � � � �, � �f ' '�(. � <br />PROJECT ADDRESS <br />� ,�� ` ,c • � � ; l.` _� � <-' � <br />�� � � <br />_ �' ; _ � c— C.. __ � � � r' , � <br />jC . �'a � �'t �� � � \ Cl� . i.:. ;`... 1 � � _ \ � . <br />1 � � '�, 1. �� �• <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />,� � <br />Elec al Contractor <br />State License Number <br />Mail Address <br />Mail Address <br />—..___-,- � ' \ <br />Proposed Use of Building <br />Description of Work to Be Done: �\ ,� .c� �• �' ` <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />City <br />City <br />State/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />/ hereby certify that 1 have read and examined this app/ication and know the same to be true and <br />correct. All p�ovisions of laws and ordinances governin� this type of work will be complefed <br />whether specified herein or not. The granting of a permit does not presume to give authonty to <br />violafe or cancel the provisions of any other state or /oca/ law regulafing consfrucfion or the <br />performance of construction. That I am authorized by fhe owner of fhis properfy to perform the <br />work for which application is made and ! comply with the State Confractors Law 18.27 RCW and <br />296.200 WAC. <br />, � r, <br />�. � <br />�`i .... � � '� '�\ �- , , i\ �� �. <br />Phone <br />Phone <br />FEE <br />�1�U2-v23 <br />