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� <br />� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8870 - FAX425-257-8857—www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 6 CREDIT CARDS ARE NOT ACCEPTED <br />��C�Z 5.'3Rn �� Lv�acrr lnJ�• `�8Z0�3 <br />PROJECT ADDRESS <br />17�v�o IC�v�,-ccn� �t90Z 5. 3''-OAvG Cv�rtcrr I.uYa- �jR2J3 <br />Owr1B� Mail Addrass Cily SlatelZip Phone <br />Tenant <br />Eledrical Contrador <br />State License Number <br />i ✓���`- <br />Proposed Usa of Building <br />Descriptan oi Work to Be Done: <br />Mail Address <br />Mnil Addruss <br />NOTE: WIRING IN NON-DWELLIiJGS IS REOUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily fhaf I have read and examined this <br />correcf. All provisions o/ laws and wdinances gov <br />whefher spea�ed lreiein or nof. The grantinp oI a <br />vblate or cancel fhe provisions o/ any o(her sfate c <br />performance olconstrudion. That I em authaimc <br />��ork lor which applicalion is mede a� I aomply w <br />296.200 WAC. <br />City <br />City <br />StstelZip <br />StatalZip <br />Contracl Price of Work <br />('.onted Person (Plan Review) <br />arM know the same to be frue and <br />ype o/ work will be complefed <br />nof presume fo give aufhady to <br />sgWafing consfrudion or the <br />er ol this property fo peAorm tne <br />Conhact�rs Law 18.27 RCW and <br />lzlz9,loz} <br />FEE <br />EoK�z-i�9 <br />Phone <br />0 <br />