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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT pERMIT SEaVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8R10 - FAX 425-257-8857 — www,everethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />_� 6 3 � ��� 1-� � �Z� �( � � �� � � J�1/ a� '� Y � ° � <br />PROJECT ADDRESS <br />�����IC+����.�tit��L�� �(�3l �.v�,����l�p���c—�.������zn <br />�wner Mail Address Ci <br />�' State/Zip Phone <br />�b�� u�adc�r �S��r���'' <br />l-/�Z� �� z �'� 7� <br />Tenant Mail Address City Slate/Zip Phone <br />�/�i�� //'.�� � <br />Electrical Contractor Mail Address <br />State License Number <br />Proposed Use of <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 />CITY OF EVERETT LOCAL SALES T,4X CO�E IS 3105 <br />I hareby certify that f have read and examined this application and <br />correcL All provisions of /aws and ordinances governing this type � <br />:vhether speciGed herein or not The granting o/ a permd does not <br />violate or cancel fhe provisions of any other state or/ocal law regw <br />oeAo�mance of construct�on. That / am aufho�zed by the owner ol <br />,vork (or whiqh applir,atiqn is made and I complv with the State Cor, <br />Ciry <br />State2lp <br />Contract Price of Work <br />Contact Person (Plan Review) <br />FEE <br />ie same to be true and <br />will be comp/e;ed <br />�e to give authonry to <br />mstruction or the <br />�perty to perform the <br />� Law 18.27 RCW and <br />� �������-� f� <br />Phone <br />