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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 - DEBIT & CRFDIT CARDS ARE NOT ACCEPTED <br />`7 �l l7 `-1 S 3� /'� . 1;,.�-r-r1�', �� G $'�� <br />PROJECT ADDRESS ✓ <br />Owner <br />Tenant <br />Eler.trical Contractor <br />State License Numher <br />Proposed Use of Building <br />'��io� S '��' <br />Mail Adtlress <br />Mail Addre•ss <br />Mail Atltlress <br />Descriplion af Wark to Be Done: \_.� 11��1Y"�'`-� <br />^ r A V 1/ <br />itil.dJw� �,M.� Fi,-'L a"�1Yu'` �,'t�G�� <br />�I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />ciry <br />City <br />City <br />��5��3 C�)3�>-�3�: <br />State/Zip <br />State/Zip <br />State2ip <br />Phone <br />Phone <br />Phone <br />Contract Price of Work <br />Contact Person (Plan Reviewl <br />(.C_ �UCiv�c�� �ltS ��`'� 5�E+%'-� <br />� CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />' I hereby certify that I have read and examined fhis applicaticn and know fhe same to be true and <br />� cerrect. All provisions of laws and orernances govemmg this type o/ work wil! be completed <br />�rhefher speci6ed he�ein or not. The grentmg o(a permd dces ncf presume fo give auihonty to <br />vielats er,.ancel the p�ovisions olany other stafe orlocal lau� regulating construction or the <br />peAormance ol cons(ruUicn. That 1 am au(horized by fhe owner o/lhis propeny fo peAerm the <br />woik Icr which application is made and I comply with the Sfafe Centraciors Law 78.27 RCW and <br />296.200 WAC. <br />�113 <br />FEE I <br />I <br />