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� <br />ELECTRICAL PERMIT APPLICATI(�N <br />CITY OF EVERETT 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 <br />�. <br />� � ���J �v e ��++- �"lal l ��>� �� <br />PROJF..CT ADDRESS � <br />Owner <br />Tenant <br />v`� � <br />Mail <br />Mall Address <br />Coniraclor 1 Mail Address <br />�� r rZ�^�' Cf��b t� � <br />Stato License Number <br />;�iC � <br />Proposed Use�.of�Building <br />Doscriplion oF Work lo �o Done: <br />Clly <br />Q'l t : - <br />Cny <br />M�� !1Lti <br />Cily <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Stale2lp <br />SlatelZip <br />CoMract Price of Work <br />Conlact Person (Plan Review) <br />I hereby certify that I have read and ext�ntined fhis application ond know fhe samo to be (ruo and <br />correct. All provislons o(la�vs and ordinances c�ovemin� (his type o( work will bo completed <br />whether speci�ed herein or noL Tho �ranting o( a permit does not presume fo �ive aufhority to <br />violate or cancel lhe Provisions o/any olherstate orlocnllaw regulating construction or tho <br />peAomiance o( conslruction. That 1 am authonzed 6y the o�vner o/ thls property to pedonn the <br />work lor which applicafion !s rriado and 1 comply �vifh the State Contractors Law 1 D.27 RCW and <br />29G.200 WAC. <br />',25� /o <br />Phone <br />Phono <br />Phone <br />FEE <br />C I cx� 1— l ZS <br />