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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETl 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 8 CREDIT CARDS ARE NOT ACCEPTED <br />�' J <br />�� = / /�5,7� � S � _ <br />PROJECT ADDRESS <br />Qwner <br />Tenant <br />r�5 ✓ <br />Mall Address <br />Mail Address <br />Cily <br />City <br />State/Zip <br />State2ip <br />Phone <br />Phone <br />/�G, r SR���� s <br />EleclriCal Contractor Mail Adclress Ciry StatelZlp Phone <br />State License Number <br />� � <br />�i :/� ���N� �I <br />Proposed1U e of Buiidir; ( <br />Description al lh'nrk to Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />Contract Prica of Work <br />Contact Pe�°�n (Plan Review) <br />FEE <br />i <br />J� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS �105 <br />1 here6y certdy thaf I have read and exemmed fhis application and know the same to be frue and <br />correcf. Ad provisions ollaws and ordinances govemrng th�s type ol work �vdl be completad <br />wnefher spaci6ed herern oi noL The gren6ng ol a permd does no� presume to grve euthonry to <br />wolate or cancel the prows�ons ol any other sfate or /ocal law regulahng construction or the <br />�Aormance o/ construchon. 7het I am authonzed by the uwner o! fhis pioperty to peAorm the <br />ork lor whrch apphca6on is made an� I ccmpry wrfh the Sfate Contractors Law 18 Z7 RCW entl <br />296.200 WAC. <br />�%: � / ���". <br />� oN ia-o4.� <br />