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ELECTRICAL 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 />APPLICATIQNS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />i :;�� ."��'t% rT%� �'�.�-f�z% �Yr k,.�-"T <br />PROJECT ADDRESS <br />�� S� �5�'/ � / U 3�_ <br />`�; f� T� f� �� i t.i, f?.:rs SDit�.?a u��2=�'�-�t' ��4�,C4 : r-%��Zc�3 <br />Owner Mail Address City State2ip Phone <br />� <br />Tenant <br />Dw� <br />Electrical Contractor <br />Slate License Number <br />�"� �L" S J � .� .- � ���c <br />Praposed Use of Building <br />Mail Adtlress <br />Matl Address <br />Descripticn of Work to Be Done: � <br />City <br />City <br />�� � J�: <br />V/)t-� L� /' i�� IS '` i <br />. � <br />� u:� i) "i � TT+< D� i r=J.t lc <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS. MC OR AC CABLE. <br />State2ip <br />Stale/Zip <br />Contract Pnce of Work <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SAI_ES TAX CODE IS 3705 <br />1 hereby ceRi7✓ fhat I have read and examined fhis applicafion anc know fhe same tn be We and <br />ccrrect. All piovis�cns c/laws and ordinances govemrng this type of work wdl be completed <br />whether speulieA nerein cr noL The granting o/ a permd dces notpresume to give aufhonty fo <br />vrolate oraancel the prcvis�ons of any other sfate erlocal law regwating construcbon or ihe <br />pederm�nt 31 constructicn. That / am au(horized by the ewner ol th�s property to peAcrm the <br />wnrk fo w �c ap cation is made and I compty wrth the Slate Ccntraclors Law i8.2; RCW and <br />296204 A . <br />�.,' /� �� C% �,�/��-� <br />�. <br />FEE <br />,E o�/r�4-�LK <br />Phone <br />Phone <br />