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E�ECTRICAL 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 />�U��� � �t�r� � r-�r� I I�� � � �� v�t, ��r1 <br />PROJECT ADDRESS <br />� <br />�r.�ack r;���i��c,��Cr����i���c��o�� �,��<< �r�i ���_ a ���ca��� <br />OWne� Afail Address City State/Zip Phone <br />Tenant <br />Elecirical Contraclor <br />�1111[ll I 1" I O(')nk� <br />State License Number <br />Proposed Use of Building <br />Mail Address <br />Mail Atldress <br />Sf <br />Ciry <br />Cily <br />SlatelZip <br />Stale/Zip <br />�Ir <br />Con�Pric� rk <br />Phone <br />yl��l3c�' <br />J��.� i �('���, <br />Contacl Person (Plan Review) <br />Description of Worh lo Be Done: UV I I�L I P I(•� C'i�1� � Ll 1 i��C�� �� 'r���' i��� \(�t /l �l(�' S�"" �- � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIR[D TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 he�eby ceriily that 1 have read and examined this ap�'rcation and knu�r �he same to 6e frue and <br />correcL All provisions of la�vs and ordinances govermn� this f}�pe o/ woik will be comple(ed <br />whefher specilied herein ornoL The c�ranting ol a perrmf does nol �esurne to give airthonty to <br />violate or cancel Ihe provisions ol any other sfate ar le,:al lnw reguPting construc6on or fhe <br />performanr.e ol construction. Thaf 1 arn aufhorized by the owner o(this pwperty fo perform Ihe <br />work lor which application is made and I comply wilh fhe Sfate Contractors La�+� 1827 RCW and <br />296.200 WAC. <br />� <br />FEE <br />� `� � <br />� c�cL- l ( z <br />Phone <br />