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r" <br />� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 3—jj� U,/ <br />425-257-8810 - FAX 425-257-8857 – www.everettwa.org ���a3 �37 <br />/ <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />'�,i-� �ti�l:;�- �rF;1= <br />PROJECT ADDRESS <br />_' %„ - <br />Owner <br />Tenant <br />Elec�rical Conlractor <br />Stalo License Number <br />ProposcA Use ol Building <br />A1ail Address <br />Mail Address <br />Idail Address <br />City <br />Cilq <br />Slale/Zip <br />Statc/Zip <br />Slatc2ip <br />ConUacl Price of Work <br />Contact Person (Plan Review) <br />Phone <br />Phonc <br />Phone <br />Descriplion of Work to Cie Da�e: _ i!�—J� r i�li; / �i-rii ;7J/-�[�:✓�r-° �-� � �f�L-f �lir1= l!r i ilr,'Hi �.-R �il/n✓� <br />/%i iiwL71! [.lPP)�i �.�iL`/� �r: iX r�l P�: �'Y�� F i� S'"i' <br />� <br />NOT[: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />B[ IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I herehp certi/}� (haf 1 have read and examineA this applicalion nnd know fhe sente to Ue true ond <br />r,orrect All provisions o( la�rs anA ordinances c�overnmg flns type o/ work �rill be cornplefed <br />❑�hefher specifieAheiein or not The ��anfing o/a pernuf Aoes nof presume ro gi��e aufhonty fo <br />violafe er cancel the �rovisions o! nn}� ofherstate or local lnir re�ulafing construclion or fhe <br />perfamance oI cons�n�ctfon. 7h ( I. rn oufhorized by fhe oisner o/ Ihis property fo pedomi the <br />wak /or �vhich applicafion is rnod a� d 1 comply rvifh fhe Sfafe Contrac(ors Lniv 18.27 RCW and <br />29G.200 N�A . i � � <br />, � . ,' � �`I f.'/ :�' : �, � ��N'1 n�v._ <br />FEE <br />� I (�YJj - (��y <br />