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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 />% �% 3� j ��. f � 5`�" <br />PROJECT ADDRESS <br />OWnef <br />Tenant <br />Eleclrical Conlrador <br />Slate License Num6er <br />)G�r (.� J o?l %� <br />Mail Addrnss <br />A1ail Address <br />M11ail Addresc <br />�C�J%�C'�� C ��'Cc � //�/ <br />Proposed Us� of Building / <br />Description of Work lo Be Done: <br />NOTE: WIRINC IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TN( CODE IS 3105 <br />' <<s�<° <br />Cily <br />Ciry <br />Cily <br />Cc/ /'�L% <br />S�atclZip <br />`I �/" <br />State/Zip <br />Stale/Zip <br />'�%� `�"� ��y3 <br />Phone <br />��( D � � / /'�v <br />Phone <br />Phonc <br />ConUact Price of Work <br />Conlacl Person (Plan Review) <br />f hereby certi/y lhaf I have read and ezamined Ihis applicalion and know fhe same to be true and <br />conecL All provisions of laws and oidinances poverning th;s type o/ �vork will be complefed <br />whefher speci/ied herein or noL The qranling of a pernut does no( presume to givr, auU�onty to <br />�-iolate or cancel fhe provisions o/ any ofher stafe orlocalla�v regulafing construclion or the <br />per/onnance o/ construcfion. Thaf 1 am authorized by the owner o/ this property to perform fhe <br />work lor �vhich application is made and 1 compty wilh fhe Sfafe Confraclors Law 78.27 RCW anA <br />f/`�- <br />/ �� / /f'CC/ <br />FEE <br />��, /�� � � <br />t � <br />