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PROJECT ADDRESS <br />i� <br />Owner <br />Tenant <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www everet+wa org <br />APPLICATIONS ARE ACCEPTED FROM 8:.M TO 4 PM <br />Mail A�tlress <br />Idatl Atltlress <br />c�ry <br />City <br />State/Lp <br />Stale/dp <br />Phone <br />Phone <br />�_� , r i � �: � I � � �� . � � I ! l' I I 1) i/� i �' � � <br />E7ectncal Contractor Man ntldress Ciry Slale/Lp Phone <br />i j, � , � , , <br />State License Number <br />Proposed Use of Building <br />F I ( . , � <br />i <br />CoMract Pnce of Work <br />. � / � <br />Contad erson (Plan Rewew) <br />�escnp6on of Wurk to Be Gone �'� �� 1 �,� `.. i _ _ _ I ' � � r' � � j u .� � . ' '� .I ' ' <br />I ll 1� � �I � � � �' �� '1 i �t i�'I I { �� !� �1 r�' � <br />NOTE WIRING IN NON-DWELLINGS IS REOUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J106 <br />I h�reby co�idy Ihaf I hdv read, nd exam�ned fhrs applir,ahon arrd know tlre sarrre fo be tn�e arrd <br />conocf All provrsons ol laws arrtl n�drnarrces goverrung fhis fype o! work wrll Ae complefed <br />w.hAfher speci6ed herem or nof The gianhng p! a pamnf does nof vesume fo give aulhonty to <br />violafe o� carrcel fhe prov�srons ol any o(her sfafr or local law regufafrng conshuchon or the <br />pe�lormance o/consfrur'hon Tlraf I am ;�u(horrzeAby Ihe owner o!lhrs property (o pe�lorm fhe <br />nro�k /or wh�ch applrceGon �s rnndr and I mrnply wvlh (Irr! S(ate Con6arlo�s Law iB 27 RCW and <br />796 200 W{1C. <br />, , <br />/;'. � j�(i •. <br />f- l�'� /-? � 1 I 7 <br />