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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 96201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� -�'t`��-�-i l;:'�'i �/�� �:- a�' <br />PROJECT ADDRESS <br />� ,. , <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />:r- Ur � :'. F- r7 <br />a�r���� <br />Cily <br />Ciry <br />C�? /�j�/S, <br />Stale2lp <br />StalelZip <br />S �i5 <br />PhoneC;� <br />Phono <br />�-� ,��- r r�i1�.,/� -i���( �h.,N• �,.' i,�'.�.+�5�� L.�- -% `-%i�'•�.� `'"' ��1v <br />' :.� t; ir'S <br />[leclrical Contraclor Mail Address City Stale/Zip Phone <br />i <br />.' , , ,�� p.� •�%f%��f <br />Slate License Number <br />Froposed Use oi Buildinc� <br />Description of Work to �e Done <br />NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CADLE. <br />CITY OF EVERETT LOCAL SAL[S TAX CODE IS 3105 <br />/i l Z ., r^ �.i <br />Contracl Price of Work <br />Contact Person (Plan Review) <br />1 hereby certily that 1 ha��e read and ezarnined fhis application and knmv the santo fo be lrue and <br />conect. All provisions o(laws and orAinances govemmg fhis fype of work wrll be complefed <br />�a�hefher speciGed herein or noL The granting o( a permd does nof �resume to give a�thonty fo <br />violafe or cancel the �rovisions ol any other stafe er local law regulafing construcfion oi the <br />pedormance ol construcfian. That I am aufhoiized by the o�r�ier o/lhis properfy fo perlomi the <br />work lorwhich application is made and 1 cornply �rith fhe Sfafe Confracrors Law f8.27 RCW and <br />29G.200 VVAC. <br />,� <br />� ��-— —-Tj �.`i � �l � (o <br />FEE <br />� ��i�> p �C'�i� <br />