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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 <br />� yC� � �U�/-e 7�� l�� <br />f�ROJECT ADDRESS <br />Owner <br />Tenant <br />Eledrical ConNactor <br />Slale License Number <br />Mail Address <br />MailAddress <br />Mail hddress <br />t�puC — <br />Proposed Use of Building <br />Squere Foolage (If residential new conslruction, remodel or addilion) <br />Descriplion of Work lo Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL 5,^,LES TAX CODE IS 3105 <br />City <br />City <br />City <br />Stale2ip <br />Slate2ip <br />SlalelZip <br />Contract Price of Work <br />yzs- <br />3 y3 _.� <br />Phone <br />Phone <br />� Phone <br />Conlact Person (Plan Review) <br />1 he�eby cerfi(y (hat 1 have read and examined tbis applicatinn and know fhe same to be tn�e and <br />correc(. A/l provisions o( laws and ordinances goveming Ihis type ol work will be completed <br />whe(herspecfied herein ornoL The granting o!a permrt does not rasume to give aufhonry fo <br />violale or cancel fhe provisions ol any other stale or local la�v reguPting consWclion or 6tie <br />pedomiance of construction. That 1 am aufhonzed by the owner o/ fhis propeAy to peAorm fhe <br />�96 2 0 WAO� application is made and 1 comply wi(h fhe State Con(rac(ors Law 18.27 RCW and <br />FEE <br />75 °O <br />C�Zo�-(53 <br />