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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 8 AM TO 4 PM <br />� C/C. � ���Ci/C'�� I � �.•�!� <br />PRbJECT ADDRESS <br />u <br />Owner <br />Mail Adtlress <br />�Cj �L�Y' <br />Tenanl tdail Address <br />�-�'�r.� W � C, �� � � <br />Electrical �oniractor Mail Address <br />Slate LicenSe Number <br />Proposed Use o( Building <br />Descrip;ion of Work to Be Donc: <br />� <br />L( l�� � � i S. r s� � r <br />U �J .S�t.�rS�' ��1.4'di(' <br />Ci�y <br />City <br />i <br />City <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 />� <br />Stale2ip <br />StaleRip <br />Sla�e/Zip <br />P�L�� �'�'S�3c <br />Phone <br />Contracl Price of Work <br />Conlacl Person (Plan Review) <br />I hcreby certily fhaf I have read and ez�arnined Ihis applicafion and know the same to be true and <br />co�recG All provisions o/laws and ordinances govemmg (h�s type o/ work will be complefed <br />whether specdied herein or noL The granfing o/ a perrnrt does not resunte fo give aufhordy fo <br />violafe or cancel the provisions ol any o(6er stafe or local la�v reguPfing consfruction or the <br />per/ormance ciconstructron. Tl�at 1 am aufhorized by !he arner o! Ihis property fo peilonn fhe <br />work �or which applicafion is made and 1 comply �ailh (he State Confracfors Law 78.27 RCW and <br />296.2 WAC. ( � <br />\ <br />FEE <br />� ,i' � �� (I <br />J <br />EO�Cco2 -I'�U <br />Phone <br />Phone <br />