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� <br />:� <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 />/b�/6- o� <br />l_=�C�6�o�oq5 <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM • DEBIT 8 CREDIT CARDS ARE NOTACCEPTED <br />c� j� O � -�. � _S-� <br />�� -��ri7'1 i .f � ��'�"1'�---- <br />P�OJEC7 ADDRESS <br />Owner <br />Tenant <br />Atlarcss <br />Mail Atltlross <br />Conl�actor MailAddicss <br />, <br />� , <br />.�o�,+P " � I�S0�7 <br />Slate Licenso Number <br />CU��1� �l ��:'_ �C>il'1�'llll I <br />Proposed Use of Building J <br />Description of Work to Be Done: <br />NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO <br />BE IN RP.CEIVAYS, MC OR AC CABLE. <br />CITY OF EVERE.T LOCAL SALES TAX CODE IS 1105 <br />L <br />-�� �c-�'r P� � <br />City StateRip Phone <br />ciry <br />StatelZip � Phone <br />Ciry SlatafZiP • Phone <br />�� I,��� <br />Contract Price of Work <br />Contact Person (Plan Review) <br />FEE <br />1'�ereby ceRi/y fha( I have read and examined fhis applicafion and know the same fo be frve and C. p��.1C - � ry � <br />r� vect All provisions o/laws and orc'inances govemmg fhis fype of work will be comp/efed <br />khethersper,ifietl herein or noL The granting ol a permrt does not resume to give authonty to <br />viola(e or cencel fhe p.rovisions oI any ofher sfate or local !aw reguPting consWction or fhe <br />pedormanae ol consfmction. That 1 am authonzed 6y fhe owner oI thrs property to peAorm fhe <br />work Ir: which appGcation is matle and I comply wifh the State Contracrors Law 78.27 RCW and <br />296.�J0 WAC. <br />