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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 />APPLICATIUNS ARE ACCEPTED FROM 8 AM TO 4 FM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />� � � L� -- ' � i <br />PROJECT ADDRESS <br />-t '� � l�"� ;V l <br />Owner <br />�', <br />�. , - <br />I i ,1i � � i� �� l� ��_J <br />Mail Address City StatelZip Phone <br />l;�,. �/`"�`l.%`(�5 <br />Tenan� Mail Address Cil� StatelZip Phone <br />�I;i.�'i. /��i��..,�,., ��, r - �iL_ ��i 'l ��,�/ (��i�i�� <br />Electrical ConUaclor Mail AdAress L'iry Stale/Zip Phone <br />Slate License Numbcr <br />Proposed Use o( Buildin� <br />' r <br />Coniracl Price of Work <br />Contact Person (Plan Review) <br />Descriplion of Work lo Bo Done: i r ' � i �H'� � �= �` - I' � � � � "'t' �; <br />. ., �; l; i i, ;-? ; ;, �,- --- <br />NOTE: WIRING IN NON-DWEILINGS IS REQUIR[� TO FEE <br />BE IN RAC[WAYS, MC OR AC CFBLE. <br />CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br />I hereby ce�tily fhal I have read and examined fhis applicafion and kno�t� (he same to be fnie and <br />correcL All provisians o(laws and ordinances governmg fhis lype ol work �rill be completeci <br />whether specilied herein ornot The �ranfing o/ a pernnf does not presur �e to give authonty to <br />violate or cancel Ihr, provisions ol any other state o� local law regWafing constn�cfion or Ihe <br />peAomiance o/construcfion. That I am aufhoiizeAby Ihe ownr.r o/ fh�s pioperty to perlorm fhe <br />�vork Ior which applicalion is made and 1 comply wifh Ihe Sfate Cnntrartors La�v 1fl27 RCW and <br />296.200 WAC. <br />�' � "� <br />i <br />•"f-/.r'.,., j. <br />`,q % <br />�� � <br />J <br />