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ELECTRICAL PE�MIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 982('1 ��_Ir <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org i o� � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM E r� �z -/6 i <br />o(SO � ��'���� �� <br />PROJ ECT ADDRESS <br />Ownet <br />Mail Address <br />r.�ry <br />Sr-r .�— <br />Tenanl Mail Address City <br />S'ti .� <br />Electrical Contractor Mail Address City <br />State License <br />�� �.-/ <br />Proposed Use of Huild+nn <br />State/Zip <br />State/Zip <br />Slate/Zip <br />��-� .� <br />Contracl Price ol Work <br />�3v •%77 <br />Phonc <br />�s".�- <br />Contact Person (Plan Review) <br />Descriplion of Work to E3e Done: �/j�iJ���� / ' ii� .��i7_�.�v.� <br />NOTE: WIRING IN NON-DW[LLINGS IS RE�UIRED TO <br />�G IN RACEWAYS, MC OR AC CADL[. <br />CITY GF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hme6y ce�1il�� Iha(1 have read and examined fhis applicntion end know Ihe sarne lo be Irua nnd <br />correct. All provrsions o/ laws and ordinances governmr� this type ol work �vill be complr,lr.d <br />whefher specdied herein or noL The �ranfing ol a pernuf Aoes nof ncsurne lo give aufhonly fo <br />'iic!a�e or cancel lhe provisions a! any of.'�ei slate or local l�iw reyu'�lin� consfrucfion or fh�� <br />perlo�mance o/ constnichon. 7hat I arn aufhonzr.d by the o�vner o11h�s��roperty fo pedorm Ihe <br />work lor wbich applir,ation is made and ! compty wi;h fhe Stafe Conlrac,ors Law in.27 RCW and <br />29&7.00 WAC. <br />FEF <br />_ l 5 L�7 <br />Phone <br />Phone <br />.� � � �Z'��� <br />