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� <br />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 B AM TO 4 PM <br />�:zy ���,�.�����r�,� <br />PROJECT ADDRESS <br />! <br />Owner <br />_ �;-•— <br />Tenant <br />Electrical Contraclor <br />:1L����vt,i``I`1'� ✓iV <br />Slale License Number <br />�— �-� l7 <br />Proposed Use of Buildinc� <br />hlail Address <br />Mail Address <br />Cj ���� ��l✓� <br />Mail Address <br />Cily <br />City <br />City <br />Slate2ip <br />StafMZip <br />��� D� , i >� � -_?i <br />Phonc <br />Phone <br />State2ip Phone <br />�l �'t <br />�3 5z� - <br />Contract Price of Work <br />`� <br />Conlacl Person (Plan Review) <br />Description of Work to De Done: �._�.� �.L � . � c.� ��-' C' �r �:./ �; ��; / �-� � -�� �"( f` <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT �OCAL SALES TAX CODE IS 3105 <br />I here6y certily fhaf I have read and exarnined this applicafion and know the sarne fo be hue and <br />conecf. All provisions ol laws and ordinances governrng fhis fype o/ work will be completed <br />whctRer specified herein ar not. The granfinc� of a pernut does nof resume fo give aufhonty to <br />violate or cancel the provisions ol any ofher sla(e or local law reguPfing construcfion or the <br />perlormance ol construcUon. That 1 arn authonzed by the owner oRhis property fo pe�lomi the <br />work lor which application is made and I compty with fhe Sfafe Conlractors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />c �lZ ��G� <br />� <br />