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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 �,. a 3-�g <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org ���04 `� � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�.� �S �U ��CG �" �� � r <br />PROJECT ADDRESS <br />o,v��� <br />Tenanl <br />��k �1�.: <br />Eleclrical Controctor <br />Maii Address <br />hlail Addmss <br />�dail Address <br />�-��. � �I�; �- -�i �r `� ��� P <br />Stale icense umbcr I <br />Proposed Use of �uilding <br />Oescriplion o( Work lo �e Done: <br />NOT[: WIRING IN NON•OW[LIINGS IS REQUIRED TO <br />E3E IN RACEWAI'S, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />Cily <br />Clly <br />�l-,�� � �' <br />Stale�Zip <br />State/Zip <br />�SYas� <br />State/Zip <br />����. a�l <br />Contracl Pi cc of Work <br />Contacl Person (Plan Reviee�) <br />1 hereby certily fhat 1 hare read nnd ea�emined this applic�fior, and knou� fhe same fo be frue and <br />conecL All p�ovisions ollau�s and ordinances got-enung fhis t}-pe ol �rork will6e complefed <br />tvhefher speci6ed herein or noL The gran(ing o/ a pernuf Aoes nof �iesume to give authonty lo <br />violafe o� cancel 1He rn�ovisions ol any other sfate or loeal law rec�ulefing r,ons(niction or fhe <br />performm�ce o/ construcfion. Thaf 1 am aufhoiized by fhe o�+ner o/ fhis :�roperfy fo perlonn fho <br />�+ro�k lor which applicafion is mad� and I conrpty �rith fhe Sfate Contracfors Lnw 18.?7 RC W end <br />29G.200 LVAC. � <br />,, <br />- -�� `� cJ <br />FEE <br />Phone <br />Phonc <br />Phone <br />