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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� <br />� ,� � <br />� �_�'J�� � ��.��� (`�,�G..�C_.T <br />PROJECT ADDRESS <br />�-'(�,"T`���5� ;n�-� f���')P;���-`� <br />Owner <br />Tenanl <br />Mail AUdress <br />Mail Address <br />City <br />r,�ry <br />Slate/Zip <br />Slate2ip <br />� �a�-o7 <br />Cd�o4�i7� <br />Phone <br />�--I L� ��� � � 15� <br />Phone <br />� <br />r � <br />�jU�(`�i('�� r ,�S Vri( �-, LCl "� �-%,i `�� �T ^Ji.) 5 � �;�J'1���I� �.,)l�� �,'r,i=����, <br />Elect�ical COnt�aclor Mail Address Cily Stale/Zip Phone <br />�����.f.rr�l��.�..�-i���^ �� <br />1 <br />Slale License Number <br />�j�- �'� <br />Proposed Use o( Buildin� <br />j(i0�1 <br />Conlrect Price of Werk <br />Conlact Person (Plan Review) <br />n r— �. , <br />Descriplion of Work lo Be Done: W: c CC� p� ��� �.�. , ��,�_ ,_, 1� �� I,r� �� ��� �;�� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CI i r OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerfi(y Ihat I have read and examined Oris npplicafion and know fhe same to be Vue and <br />conecL All provisions o/ la�vs and ordinances �ovenung this t}�pe ol work will 6e completed <br />whelher speci6ed herein or noL The �rantinc� ol a pemid does not presume (o give authonty to <br />violafe or cancel Ihe provisions o(an}� other s(ale or local lan� re�ulatinc� construction or the <br />performance oI construchon. That 1 arn authorized by the o�vner o( th�s properly to perlorrn the <br />work lor �vhich applicafion is made and f cornply with fhe State Contractors Law 18.27 RCW and <br />296200 WAC. <br />FEE <br />