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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98�01 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� �_ , � � <br />�i <br />PROJECT ADDRESS <br />,. ��, � j 4 i l ) <br />��li� <br />Owner M1iail Address <br />Tenant <br />Electrical Contraclor <br />State License Number <br />i pos� d Use ol Building <br />Descr+p�ion of Work lo Be Done: <br />tdail Address <br />Mail Address <br />1 ?� r�;; ,�,`. <br />Giy <br />City <br />State/Zip <br />State2ip <br />City Slate2ip <br />� ���;c,o �;�, <br />CoNract Price o( Work <br />Phone <br />Phone <br />Phone <br />Contacl Person (Plan Review) <br />i <br />,�, I T' � <br />1,�;(� ; i � LC��+7�f �,' � h'< <ti��l��� �� ��1�� tl7 ( l�� , �� � <br />NOTE. WIRING I�: NON-DWELLINGS IS REallll�[D TO <br />Q[ IN RHCFWAYS. MC OR AC CABL[. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 herebvi certily thal l have �ead and examined fhis ��p'icatfon and knuiv the same to bo frue and <br />cnrrecl All prov�sions ol laws and ordmances gover �ung this type o/ wurK will be completed <br />whelher specilieAherein or nof. The gran(ing ol a p�rmirt does not �ieswne to give authorit}� fo <br />violate or cancel the provisions o/any other sfafe or loral law regulafing construcfion or the <br />perfo�mance o/ construcfion. That I am aufhorized Gy vhe owner of this propeRy fo peAorm fhe <br />work Por irhich applicafion is made and 1 comply with fhe S(afe Coniractors La�v 7827 RCW and <br />29&200 WAC. <br />' i�� � � <br />� � . , , -��.���i�', <br />FEE <br />