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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�,� ,, - , � <br />/ <br />��-- � � �; <br />PROJECT ADDRE5S <br />Owner / <br />! iil,l�/ �� <br />Tenant <br />� i (` <br />' �' ' '�� (.d. <br />,�; <br />Eleclrical Coniractor <br />Mail Address <br />�- � i: <br />C '. ' <br />Mail Address <br />Mail Adtlress <br />. <br />Slalc License Number <br />l � �r�ir�.r.rC <br />Proposed Use of Buildkig <br />Descriplion of Work �o Bo Done: ' �� �i�� � �' �� -%�<<.,'f <br />�_" �:i( _ <br />NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />City <br />Gty <br />Stale/Zip <br />Slate�Zip <br />Ci1y StatelZip <br />/ <br />�� " i�: <br />Conlract Pnce ol Work <br />/,' <br />i ��� ��i <br />Conlacl Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ce�tity fhal 1 have rcad and exarnined fhis applicaf�on anA know fhe same fo be true and <br />conrcl. All provisions o/laws and ordinances c�overning (his fype o/ �vorh will be cernpleted <br />�vhefher specilied he�cin or noL The grantin� o! a perrnd does not presume lo grve aufhonty fo <br />viola(e or cancel the prot�isions a) any ofher sl��le or local la�r regulafing cons6ucfion or fhe <br />performance of cons(n�ction. That I.�m aufhoii,ed b}- the o�vner ol fhis property to perfomi fhe <br />work lor which application is made nnd I cornply �rdh fhe Stale Confracfor's Law f8.27 RCW anU <br />29G20J WAG. <br />I <br />FEE <br />� �����7 �� � <br />�, : � <br />>i�'- �ss _; <br />Phone <br />Phonc <br />Phone <br />