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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREEI�, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICAI'IONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� j �,.�� ��i <br />PROJECT ADDRESS <br />� ,,r .. �`� �.�. <br />Owne� Mail Addmss <br />� � �� �i r � <br />Tenant <br />� �J,lc� <br />Eleclrical Conlrac�or <br />f.lail Addicss <br />M14ail Address <br />2�1L�� Z.L"�� <br />City <br />City <br />Cit}, <br />Stale License Number <br />'�� �..:. ,. . . „�.. .. <br />Pwposed Usc of Duildiny <br />Descrip�ion of Work lo Be Done: _ -� �'- � �� - � "> � <br />!t ���'t� <br />NOTE: WIRING W NON-DWELLINGS IS REQUIRED i O <br />BE IN RACEWAYS, MC OR AC CABLE. <br />i <br />� � �; <br />'�_y.,,�� `��.�'� <br />StatelZip <br />State�Zip <br />���. � , ` <br />��J_�_ <br />Phone <br />Phone <br />State/Zip Phane <br />Conlract Price of Work <br />Contact Person (Plan Review) <br />� <br />1 <br />\•,�.',�C'.�\ ��,cl'. ��,1_�.1'Cc� LTd1� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily that I have �ead and examined this application and kno�v the same to be Vue and <br />correcL All prowsions ol laws and ordinances gove�ning this type o/ werk will be cornpleted <br />�vhether spec�6ed herein or noL The g�anting of a pemut does not resume to give authonty lo <br />violafe or cancel ffre provisiais ol any olher state or local lau� rec�uPting construcbon or the <br />perlorrnance ol consfrucGon. Thaf 1 am aidho�ized by the o�vner o/ this property to pe�form the <br />�vnrk /or �vhich application is made and I comply �vith lhe Sfate Contractors Law 18.27 RCW and <br />2d6.200 WAC. <br />� _ � _ '��, ,��,� <br />i� l t l�� ; <br />FEE <br />: � L ///� / j�i <br />