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ELECTRICAL PERMIT AP�LICATION <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 />'.>Z`� ��o`�� lA)C��i <br />PROJECT ADDRESS �— <br />Owner <br />Tenant <br />Electrical Conlractor <br />State License Numher <br />Praposed Use of Building <br />-�-�.� � �'I �.0 <br />Mail Address <br />Mail Address <br />Mail Address <br />1� �U2`� <br />City � State/Zi� Phone <br />�;tu�I I-�o , <br />U �� -�I `7� - ���5 e� v�- <br />City Stale/Zip Phone <br />City State2ip Phone <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: 1�-� ��I °'� � � b'` � I�v/� I�v �i/�'L�� � <br />i-- <br />� 1tit CQ <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />FEE <br />I hereby certily that I have read and examined fhis application and know the same to be true and <br />correct. Al! provisions o(laws and ordinances goveming this type ol work will be completed <br />whether specified herein or not. The granting of a permd does not presume to give authority to <br />violate or cancel the provisions ol any other state or local law reguleting construchon or the <br />pedormance of construcnon. Tnat / am authonzed by the owner uf this prope�ty to peAorm the <br />work tcr which application is made and I comply wRh fhe State Contractors Law 19.27 RCW and <br />296.200 WAC. <br />Signature Date <br />F��l�z- �IZ <br />