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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-885i —www.everettwa.org <br />APPLICNTIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�a� i�,����� <br />PROJECT ADDRESS <br />�.���(�e �,s�tir��� <br />Owner Mail Address Cit/ Stete2ip Phone <br />Tenanl <br />Mail Address <br />City <br />State/Zip Phone <br />�c�z �1��� ;��. � ��� i�:��; r s��,����-F � s�� �as-�,�i�5 <br />Eleclrical Coniracto� Mail Address City Stete2ip Phone <br />�F' �ly,E3� <br />State License umber <br />_� � <br />Prapos�se of Building <br />Square Footage (If residential new construction, remodel or addition) <br />i c �, r <br />Description of Work to Be Done: �i �' <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 />Contrad Price of Work <br />Contact Person (Plan Revlew) <br />1 hereby certily that 1 havo read and examined this applicetion and know fhe seme to be true and <br />correcf. All provisions ollaws and ordinances goveming this type of work will be completed <br />whetherspecified herein ornot The granNng o(a permit does notp resume to give authority to <br />violafeorcancelthe provisionsa/anyothersfateorlocallawregulefingconstructionorthe <br />peAormance o/construction. That I em authorized by the owner o/this pmpeity fo perfortn the <br />work (or which application is made nnd I comply wifh (he State Contrac(ors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />75�`' <br />�rzc8- (5 <br />