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� <br />� <br />�LECTRICAL PERMIT APPLICATION <br />CIT Y OF EVERETT PERMIT SFRYICES ��� _�.} <br />3200 CEDAR STREET, EVER�TT. WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org �/�g��(� <br />APPLICATIONS ARE ACCEPTED fROM 8 AM TO 4 PM <br />z 3 / (� �'Vic /�o� <br />PROJECT ADDRESS <br />Mail �ddress <br />Ciry <br />C4� s) 7sy-3 <br />SlalelZip Phone <br />Tenant t.tad nAdress Cdy SlatelZip <br />s`/L�j �ve�yrcen wtir-�Dy3v <br />�r����"�F�r�-ef�� �lY� � S 2 0 ;� �yl s) <br />EI ical Conlrac�or MaA IldAmss .:�ry Slaie2�p <br />��RrGN :� 9�z� � <br />Stale Ucense Number Conlract Price of Work <br />SF/J <br />Proposed Use of Bwlding <br />Square Foolage (If residenlial new construcbon. remodel or adddion) <br />Contacl Person (Plan Review� <br />�I cG' �� a----� � <br />Description ol Work to Be Done� �P (`I/�� C� <br />NOTE: WIRING IN NON-DWELLINGS IS R[�UIRED TO <br />BE IN RACEWAYS. MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certdy Ihaf I have read and caamined Ih�s aPF'lication and know the same lo be Inie and <br />couer.l All pravrsions ollaws nnd orArnonces governrng Ihis rype ol �vuik �rdl be compleled <br />irhelher specAied hr.reur or nof The gran6n� ol a pemuf does nol I�rr.sunte fo givc auihority to <br />violal�� or cancel Il�e provisions o/any o(her stale or local !aw regul.�hny conshucfion o�� fltB <br />perronnance o� consrrucrion. rnar i am ,vdhonzed by Ihe owne� o� (lus pmperty to perform the <br />work lor w0ich apphcalion �s ntade anA 1 cornpty �+�dh Ihe Sfafe Conhaclors Law 78.27 RCW and <br />29G200 WAC. <br />Phone <br />Phone <br />FEE� �� <br />��20�i�Ll ( <br />Z�Z <br />