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� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES q / <br />3200 CEDAR STREET, EVERETf, WA 98201 /D —�%`� �J <br />425-257-8810 - FAX425-257-8857—www.everettwa.org � pG/O `�[f(` <br />7 <br />PROJEr,T ADDRESS <br />Owncr <br />Tenant <br />I'i. �, <br />El�clric�l Conlraclor <br />� <br />License Nuinber <br />ProposeA Use of Building <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />, <br />Afail Address <br />M�il Address <br />Mail Address <br />Description of Work lo De Done: i��� � <br />NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />City <br />Gty <br />Clty <br />a <br />Statr/Zip <br />StalelZip <br />I�„ <br />Slate/Zip <br />�_ , <br />Contract Prico o( WorY. <br />,'. <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I l�r,reby cerGly thaf 1 have �cad and exarnined (his applicn6on t+nd kno�v fhe same fo Ge f�ue and <br />cwrecl. All provisioos o! la�vs and ordinances govemmg this type o! work will be completed <br />�shelhcr speciGed herein or noL The granfing oi s pannd does nol presumo fo give aufhority fo <br />violnte oi cancel the provisions ol any ofher stafe o� local law re�ulating consVuction or fho <br />perfonnance o/ consf�uction. Thut 1 nm autho�ized Gy fhe ott�nr.r o/ this property to pedonn the <br />work for which npplicafion is rnade and 1 cornply �vifh fhe State Con6actors Law 18.27 RCW and <br />296200 l4�AC. <br />FEE <br />[-04' li� -i%�-��-1 <br />Phonc <br />Phone <br />Phone <br />