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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-� �7-8810 - FAX 425-25Y-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 Ayl TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCE!'TED <br />,. <br />�/ ' � , <br />�(� �c� i i9f`or. �..� , �,,�crc,tt Le+ <br />PROJECT ACIDRESS <br />�� bL�-� <br />Owner <br />Tenant <br />1�.�„�.:. i <br />M11aJ Add�ess <br />Mail Adtlress <br />�<< ri�'�l1 4u� <br />Conlractor Mail Adaress <br />.,�i�����n� <br />State License Number <br />Proposed Use of Bullding <br />Descriptian ol Wark lo Be Done: <br />`� , <br />fJOTE, �'JIRING IN NON-DWELLINGS IS REUUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY GF EVERETT LOCAL SALES TAX CODE IS 7105 <br />� <br />City <br />City <br />�z <br />City <br />�as <br />Slate/Zlp <br />Sfate/Zip <br />State2ip <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />� nereb � r,crnh� fhaf l lr;. vn rearl unc] e,earnrned Ihis apohca6on end know the same to be frue and <br />; rrec' All piovisions ol iaws antl o�tl�nances gocernrng fhrs (ype al work wdl be comp/eted <br />.vliefYer speci6en nerem or nof. The yranfmy ol a permrt dces not oresume lo groe authonty fo <br />. ielere or cence� fhe provisions ol any olhe� s�ete or local law regidetmg construchon or the <br />pe.lormance ol construc6on. rhaf I am aut��crrren bv fhe o�vner ot this property (o peAorm the <br />��ork lor wnich app6caGon rs maue aria i c.�nn:n� �wf!i fhe Stafe C�ntract^rs Law 'B 1' RCW antl <br />196.200 WAC. � <br />� �,-f � {.-(�1 r � ��`� <br />�ynamre � � 0 e <br />FEE �� <br />� �� � <br />Phone <br />P, ione <br />Phor.a <br />