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ELECTRICAL PERMIT APPLICATION <br />�-�� � <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />CITY OF EVERETT PEI2MIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />Mail Address <br />A1ail AAdiess <br />Eleclrical Conlractor Mail AJdress <br />FI�(C 1,^ Gr M� q I z I� � <br />Slate License Number <br />Proposed Use of Building <br />Square Footage (If residential new conslruction, remodel or addition) <br />Description of Work lo Be Done: <br />City <br />Cily <br />SlalelZip <br />-� �a3 ��Z�) <br />G-i�,��vq�6 <br />Phone <br />-z5� <br />phone <br />�'���–. <br />Slale2ip Phone <br />�I s-U�� UJ <br />Conlracl Price of Work <br />�i �� '� li(l��(4 � <br />Contact Person (Plan Review) <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SAI_ES TAX CODE IS 3105 <br />1 hereby certily that I have iead and examined this applicatinn and know fhe same to be Vue and <br />correcL All provis�ons o(laws and ordinances governmg this lype ol work will be completed <br />whether specdied herein or not The granting af a peimrt does not presume to give authonty to <br />violafe or r.ancel the provisions o(any ofher stafe or local law rcgulating consfrur,tion or the <br />pcAormance a(construction. That I am authorized by the owner of this propeAy fu perlorm the <br />work lor which application is made and I comply with fhe Stafe Confractors Law 18.27 RCW and <br />296.200 WAC. <br />� <br />FEE <br />L�?��--c�g <br />