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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 />v � i 8 �/P.mm,"r� �� . <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail <br />Mail Address <br />City <br />State/Zip <br />State2ip <br />Phone <br />Phone <br />�a �r,�Wc�t^ �L �J7 /R'%'' T�r ,�r/� %an (�t 9�'J' �Lo �7-/ Eii.7 <br />Electrical Contraclor Mail Address Ciry State/Zip Phone <br />�t�%/ _ 9�1 / �� <br />State License Number <br />��I'l�.l iRM��J r�ivlchcP. <br />Propo d Use of Buiding <br />Descriplion of Work to Be Done: <br />W } �n -1 �� � T S'�t?T <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVEREiT LOCAL SALES TAX CODE IS 3105 <br />� � P,ov . ao <br />Contract Price of Work <br />Contact Person (Plan Review) <br />1 hereby certily tliat I have read and examined this applicafion and know the same to be true and <br />conecL All provisions of laws and ordinances govemmg this type ol work will be cornpleted <br />whether specified herein ur noL The granting of a perrnit does not resume to give aulhority to <br />vio/ate or cancel the provisions o! any otiier slate or local law reguPting construclion or the <br />perlormance oI consfruction. That I am authorizeU by the owner o/ fbs propeRy to per(orm Ihe <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />/ �� (/O `� <br />L U �� <br />FEE <br />