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� <br />� <br />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.everethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />� 7 N: <br />,��c_'� .Sc� G <br />PROJECT ADDRFSS <br />3oD— <br />7nuc�las C��/�es 195u} i�7 aVE NE r�R���-7v�, W� `j��L3 �Js:�iG' <br />Owne� MailAOdress City Stale'Zip Phone <br />�� � <br />Tenant <br />���vN!/"� <br />ElecMcal Coniractor <br />State License Number <br />Mail Address <br />tdail Address <br />Proposed Use of Bwlding <br />Descnption of Work to Oe Done: /�_ �^ ��V I u' y C� 1`� <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 �105 <br />City <br />Cdy <br />� 4 1 <br />State/Zip <br />Siate/Zip <br />Contrad Price of Work <br />�4� l 1 �� <br />Conlact Person (Plan Review) <br />I hereby certily fhal l have read and examined fhis application and know fhe same fo be true and <br />correct All p.rovisions o/laws and o�dinances govem�ng this type o1 work will be complefed <br />whefher specified herein or noL The gran(ng o/a pennd does not presumo lo grve aufhority fo <br />wolafe or cancel the prov�sions ol any ofhe� sfafe or local lan� regulating constn�ction or the <br />pedormance o/ consirucfiort That 1 am aufhortzed by fhe rnvner ol fhis property fo pedorm fhn <br />work /or which application is made and 1 compty wifh the Sfate Contractors Law 1827 RCW and <br />296.200 WAC. <br />/ /7`L /y /,/i"G %y /r/��/� / <br />( <br />FEE <br />��-fG7-IU�j <br />Phone <br />Phone <br />