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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERE'TT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wvnv.everettwa.org <br />APPLICATIONS ARE ACCEPTED F, OM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />� �� 2 <br />PROJECT ADDRESS <br />��-�-�- <br />Owner <br />]r}�tt� <br />Tenant <br />Electrical Contractor <br />State license Number <br />Proposed Use of Building <br />' "el% Yl'l 1 �tJ�} % <br />��7-e r-e,� <br />Mail Addrees <br />Mail Address <br />Mail Address <br />�4� <br />� <br />Descnption of Work to Be Done: I� �L��,17r� `a� <br />`��c�. ���k 53 � ����Ce� �a�v� <br />Gty State2ip Phone <br />�(ZS���06�� <br />City State/Zip Phono <br />�ity <br />Slate2ip <br />Contract Price o( Work <br />Contact Person (Fla� Review) <br />a -�e�U(c-� i�C>U( <br />� ffi— s ���-PiI <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACE��AYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />I hereby certily fhat ! tave read and examined this application and know the same to tie true and <br />correct. All provisions o/la�vs and ordinances govemmg thi: type ol werk will be complefed <br />whether specified herein or noL The granting o7 a perm�t dcas not oresume fo pivA �ufhonty to <br />v�olate or cancel the p�o��isions c(any other state orlecal la�v regulating const�uction or the <br />wo�k lerawh ch appl catbn s a�de and / complyedth fhe State Contrac:orsP a�v 18.27 RCW and <br />296.200 WAC. <br />�� <br />�d'iIU •d�`-� <br />FEE <br />Phona <br />