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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT S�RVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />C� <br />��1�-�v'"� <br />PRCJECT ADDRESS <br />Owner <br />Tenani <br />Contraclor <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Idail Address <br />Mail Address <br />L �t'�- � r< <- <br />Mail Address <br />D��v� E �l r��� r3� <br />State License Number <br />I� r� s <br />Proposed Use of Buildiny <br />Descriplion o( Work lo �e Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />8E IN RAC[WAYS, MC OR AC CABLE. <br />CRY OF EV[RETT LOCAL SALES TAX CODE IS 3105 <br />� <br />'/�"�O/ <br />Ciry State/Zip <br />City Slale/Zip <br />City Stale/Zip <br /><l <br />Contracl Price of Work <br />ContactPerson (Plan Review) <br />�_ r r; o�. 1 -l- �� 5T� <br />}� cerfily th,�t I have iead and exarnined fhis applicalien and knoiv the s-�me to be frue and <br />. All provisions ol/aws and ordinances governinr� Iliis type o( work u�'d be completed <br />v specdied herein or not. The g�anling of a pemut does not resume fo give aulhonty to <br />or cancel tha provisions o(any ofher sfafe or locallaw reguPting construchon or the <br />iance ol construc6on. That I am aufhorized by the o�vner ol (his property to peAorm fhe <br />�r yvhich application is �jade and I comply with the State Confracturs La�v 18.27 RCW and <br />`7, <br />� aScR -� 3v <br />FEE <br />Phone <br />Phone <br />Phone <br />