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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT �>ERVICES <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 />""-i� — 'fI� f 1; r- <br />PROJECT ADDRESS <br />i i� � _ <br />C �7 � �,� /� <br />Owner� <br />Tenant <br />"� � .—�� <br />Electrical onlractnr <br />State License Nmnber <br />Proposed Usc of Building <br />hlail Address <br />Mail Address <br />61�i1 Address <br />Descriplion of Work lo Be Done: 'ti ?t�-- <br />�; �c� �cz � <br />NOTF: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, �4C OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />City <br />.-� �i'- �5=,;t7 ( <br />Statc�Zip Phonc <br />Slnte/Zip Phone <br />State2ip Phone <br />�' (�OG <br />Contra PriceofWork <br />ii ;�' <i'_ -(' <br />Contacl Person (Plan Revicw) <br />� �'- . <br />I hercby ceiiil}� thnt 1 have read and exnrnined fhis application and pno�v fHe s�inre to be true and <br />correcL All provisions o( laws and ordinances governmg Ihis fype oI work will be cornplefed <br />�t hether specilicd hercin or noL rhe granfing oI a pernut doas not presume fo give authority fo <br />violafe or cancel fhe provisions of any ofber sfafe orlocal law mgulafing construction or the <br />perlonnance o( conslruc6on. Thaf I am authorized by the o�vner ol fhis property fo peAonn Ihe <br />�vork /or which application is made and 1 comply �vifh Ihe Stafe Confracfors Law 78.27 RCW and <br />296.200 WAC. <br />j; -- -,i , .' �' . ,/i�/ - <br />FEE <br />�ds��-�7q <br />