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ELEGTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET. EVERE'TT, WA 98?.01 <br />425-257-8810 - FAX 425-257-8857 — wv�nv.everettwa.urg <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />'/:; '� f <br />_ �' .�i; !�l_ � �„�,��fi L,JA �i �.'�is <br />PROJECT ADDRESS <br />�.�•�,,� }���. � �ir �rl�'I tl '� ��1 ..�J WA `�.��101 �'�ZS 2Sz <br />OWnef "9ad Addres� Gly Stale'Zip Phone <br />Tenant <br />� � W �ti E�� <br />Electrical Contractor <br />Number <br />Proposed Use of 6uildin� <br />�dail Address <br />�1ail Address <br />Descriptiono(WorkloBoDone: �r�l���__-�'��'����c.- <br />NOTE: WIRING IN NON-DW'ELLIN�S IS REQUIRED TO <br />BE IN RAC�WAYS, MC OR AC CABLE. <br />Cily <br />Cdy <br />State/Zip <br />State2ip <br />Contract Price ol Work <br />Contacl Ferson (Plan Ruview) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I here6y cer;ily fhaf I have reaAond examined Ihis applicafion and kr,o�v fhe sanre fe• b; frue and <br />conecL All pr�.asions o/ laws anAordicances governing this lype oI �vork will he cornpleted <br />whether speulied herein or noL Tha granting ola permd does nof pres�me to gi� e autF.ori(y fo <br />ciolafe or cancel the Provisions ol any olher sfaie or loc::l law regulatine� construction or the <br />performance o( cons�ruction. Thsf I arn aufhonzed by fhe owner o/ ihis property lo pedorm fhe <br />wcrk foi which a,oplication is made and f cornply wi(h flre S(a(e Confractors Law 1?.27 RCIh' anA <br />: ''6.200 WAC. <br />�_�?.' -/ ;�%.') �.�� <br />i <br />FEE <br />��"'L��Y ' ��l <br />iv5 r�. <br />Phone <br />Phone <br />