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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERET� PERMIT SER\/ICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIUNS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />��J��" / /�(//�e�/� �f,G <br />PROJECT ADDRESS <br />G� c''c� �i��l.t'�4rVJ, �./f�E'// <br />1� <br />Tenant <br />M11ail Addre::s <br />Mail �ddmss <br />City <br />I/I <br />�y <br />Slate2ip <br />yaS- dr* - <br />Phonc <br />State/Zip Phonc <br />-�u9�iE.P <br />Electrical Contractor Mail Address City Stat=/Zip Phone <br />Slal� License Number <br />Proposed Use of Buildin� <br />Description of Work lo Be Done: <br />Contract Price of Work <br />Conlacl Person (Plan Review) <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 />I hereby ceriily that f have read and examined this application and kno�v Ihe sarne fo Ge t�ue and <br />correcL All provisions o/ laws and ordinanccs goveming fhis typa o/ work will be completed <br />whrther specibed herein or not The granfing o/ a pennd Aoes not resurne fo give aulhority fo <br />violate or cancel fhe provisions o/arry ofher state orlocal law re�uPting construclion or the <br />peAormance ol consfruction. That 1 am aulhorized Gy Ihe owner o! (his property to perform Ihe <br />woik lor which applicafion is made ar?d 1 comply with the State Contractors Law 18. �7 RCbV and <br />29�.200 WAC. . . <br />FEE <br />�� ; c� � - 3 ��� <br />