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ELECTRICAL PERMIT APPLICATIO�V <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 />�Z� % t�1/"� <br />PROJECT ADDRESS <br />Owner c� <br />< <br />Tenant <br />C� �-{���� %B� <br />Address <br />Mail Address <br />Eleclricai ConUactor Mail Address <br />City <br />(�rzu uliGr�%`� <br />��.+5%�%�9'��fRJ� IZ�1��12� <br />State License Number <br />�1�� >�� �t%���L " <br />Proposed Use oi Building <br />�� <br />Description of Work ta Bo Done: <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 />City <br />State/Zip <br />�-a5��� <br />�llo°I-Fi3 <br />State/Zip ��� <br />r,�— 9d'�7 <br />State2ip <br />� SG�� d== <br />Contrect Price o( `Nork <br />� <br />,ld n �z , <br />Conlact Person (PI Review) <br />1 hereby certily fhat I have read and examined fhis aNplication and know the same lo be tnie and <br />correcL All provisions o(laws and ordinances goveming this type o/work will6e complefed <br />wherher specified herein or noG The granfing of a perm�t does not presume to give authonty fo <br />violafe or cancel fhe provisions of any other stafe or local law reguleting construcfion or fhe <br />perfomiance of construction. Thaf 1 am authorized by the owner ol fhis property fo perform the <br />work (or which applicafion is made and 1 comply with tho Slafe Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />Phone <br />Phone <br />Lf�� <br />.� <br />Phone <br />