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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 C�DAR STREET, EVERETT, V��A 96201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />/ �� / / <br />) ?�� �� f'��l�l(;°'A i /�t i-:!C( <br />PROJECTADDRESS <br />Owner <br />Tenant <br />Mail Addwss <br />Mail Adtlress <br />Eleclrical Cqr7trector /�� � Mail Address <br />i�'/�it .' f.��['T/r,c/ L /2c'f�Ci(. <br />�iti`;' ��, < �; s�C� �- <br />Slate License Numbzr � <br />�'7kJ � ��liUS £ <br />Pr posed Use of Building <br />Description of Work to Be �one: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Ciiy <br />Ci�y <br />� <br />=�,Z�--,� 3 -Y�7fi <br />Phone <br />Slate(Lip Phone <br />City Stata2ip Phonc <br />�� <br />/.SGi `� <br />Contract Pnce of Work <br />��1 ,/-1,s�e /;�n_' <br />Conlact Person (Plan Review) <br />FEE <br />�e, <br />��/ <br />I ne; eby certily that I bave read and examined fhis application and know Ihe same to be frue and <br />wnec! All provis�ons o/ laws and ordinances govoming thrs rype ol work will be completed <br />�vhether speci/ied heroin or noL Tho granting ol a Ferrnd doos not prosume to give authonly to <br />violate or cancel fhe provisions ol any other s(a(e or local law rogulatmg construcfion or tha <br />podonnance ol consfniclion. Thaf I am authonzed by fbo owner o/ fhis property (o pedorm tho <br />work Por which applicafion is rnada and I comply �wfh fho Stato Confractors Law 1827 RCW and <br />296200 WAC. <br />i'SiLI/ '. _ <br />i <br />Eoso3-� <br />,�3,�0 <br />/� <br />