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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT RERMIT 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 />� ���� � �' �� � r , �,' i <br />PROJECT ADORESS / <br />i <br />� - '�' �� � � �_ � _ � _ � � , <br />� <br />�� � ��' �� �, .'�_ �"�4 <br />, .� <br />Ov:ner A1ail Hddress Cily <br />Tcnani hl;iil AAdress City <br />Eledrical Contractor Matl Addicss <br />Slale License Number <br />Cily <br />S��ic2ip <br />Stalc/Zip <br />Slile�I.in <br />Conlrad Price of Work <br />Proposed Use o( �uildiny Conlacl Person (Plan Rceicw) <br />C <br />Phonc <br />Phone <br />Phcnc <br />NOTE: WIRING IN NON-DWELLINGS IS P.EQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TFU( CODE IS 3105 <br />1 hereby certily that I have read and eaarnineJ this epplicafion and know flie sama fo be Irue and <br />wnecf. All pravisions o/ laws and ordinances govemmg this type o/ work will be cornplefed <br />whether speaGed heirin or nof. The granfing oI a pernu( does nut preswne fa give aufhority to <br />violafe or cancel Ihe provisions ol any other sfafe or local law re�ula(ing construcfiun or fhe <br />performance o/consfruction. That I am authorized by Ihe owner ol fhis property fo peifemi !he <br />�sork lor which applitalion is made and 1 contpty �aith Ihe Stafe Confractors Law 7827 RCW and <br />� , � <br />'S "_ � �1 , <br />FEE <br />�J <br />.- �,..�C^;�� —C: %.J � <br />� i; <br />i_ � <br />