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ELECTRICAL PERMIT APPLICA710N <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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />5 7/0 - <br />PROJECT ADDRESS <br />ili <br />t71= 1,�,' � Ui �` � `� <br />8��1�R1���1= <br />Owner <br />Tenant <br />PAail Atldrr,ss <br />Mail Address <br />/V}c::�N� Li�lJ12)� <br />Electrical CnnUaclor Mail Address <br />�,.tC��uJ=.C�O�N� <br />State Licensc Number <br />Proposed Use of Buil�ing <br />Description of Work ta Be Done: �—�+ �: � V1 <br />NOTE: WIRING IN NOv-DWELLINGS IS RFQUIRED TO <br />B� IN RACE`lJAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />Ciry <br />Ciry <br />S iJl�l d� <br />StalelZip <br />State/Zip <br />Slale2ip <br />Coniracl Price of Work <br />Contact Person (Plan Review) <br />I hereby ccrtily fhat I have read and examined this application and know fhe same to be (rue and <br />correcf. All provisions o/laws and ordinances r�ov�rmng this type o(work will be completed <br />whe(her speci6ed herein or noL The granting o/ a iemtd does not resurne fo give aulhority fo <br />violate or cancel the provisions oI any other state r r local law reguPting construcfion or fhe <br />performance of construcbon. That 1 am authorized by the owner ol this p�operty to perforrn Ihe <br />work lor which applicafion is rnade and 1 comply �vifh the Slate Contractors Law 18.27 RCW and <br />296.200 W�;C. <br />� �' ,� � <br />s �,�m« __� <br />FEE <br />Phone <br />Phone <br />Phone <br />