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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 />�l (� I �1 r'(�o�qa� %c�, <br />PROJECT ADDRESS <br />Tenant <br />Mail Address <br />Mail Address <br />City <br />City <br />State/Zip <br />StalelZip <br />Phone <br />Phone <br />�i,,�n�;�- � 1ec�`�L F� ?�3 a6�'?s-, S7a�c.,u'� 9��a9 ��125 3o�-s�S9 <br />EleCtriCal ContraCtor Mail Address City Stale/Zip Phone <br />� �,� r��P � C�-11 3 <br />State License Numb r <br />Proposed Use of Building <br />Deccription o( Work to Be Done: I FAJ� � 5 E'�U Z�. C <br />NDTE: WIRING IN NON-DWELIINGS IS RECIUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I hern6y certily that I have read and examined this application and know the same to be true and <br />correcL All provisions o/laws and ordinances goveming this type ol �vork �vill be comp/eted <br />whether speci6ed herein or not. The granting oI a permd does not presume to give authonty to <br />violate or cancel fhe provisions of any other state or /ocal law regu/ating construction or the <br />peAormance o/ construction. That I am authonzed by the owner o( this property to perform Ihe <br />work tor which application is made and 1 omply with fhe State Contraciors Law 78.27 RCW and <br />296.200 WAC. <br />��,��. , �,���as_ <br />FEE <br />Eo��U�l—G �� <br />