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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEOAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AhM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />�—Il��.\ R3'd('l, 5 c..� c<,ts Zs+z9 E„� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />� �� I; <br />Mail Addmss <br />Mail Aedress <br />City <br />Clty <br />Slate2ip <br />Slato2lp <br />359 - lo� <br />Phone <br />Phone <br />��.....r �le�l-•« �s� 4a<<D., s,�. �-�-.� c.�4 �Sa-� -9oq�, <br />Electrical Conlractor Mail Address City Stale/Zip Phone <br />State License N �mb� e� <br />Propoced Use af B iilding <br />Descriplion o! Work to Be Done: I`e�.,� � <br />NOTE: WIRING IN NON•DWELLINGB IS REOUIRED TO <br />BE IN RACEWPYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contracl Price ol Work <br />Contact Person (Plan Review) <br />I lrereby certi/y fhat I have read and exammed thrs applicafion and know fhe sama fo be frue end <br />correcL All piovisrons ollaws end ordmances govemmg this type ol woik wrll be completetl <br />whether specdied herem or no[ The grnn6ng ol a peimd dnes net presume te give eufhority to <br />vinla(e or cancel fhe prowsions oleny ofher stafe or local law regu/eting consfrucfion or the <br />perlormance o! consfiuction 7' at I am authonzed by fhe owner o/ fhis property fo peAorm the <br />work lor whrch application is de and I cemply wdh fhe Stete Contractors Law 78.27 RCW and <br />296200 WAC. i <br />FEE <br />//D — <br />