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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.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />.3 � � 2- �,�' � ������ ��--�� <br />PROJECT ADDRESS <br />��{��l �-� �M S � <br />Owner <br />Tenant <br />.�ic�.-� ,r— <br />Electrical Contractor <br />State License Number <br />Proposed Use of Building <br />� ,. <br />1l%ZC>�.`f�� <br />Mail Address <br />Mail Address <br />Mail Address <br />� <br />Description of Work to Be Done: -��'� �`j e- <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />�; L %. �'- `/ S � <br />/ °� Z <br />!),� � (_ . ��,,w ,(� �,��� `/�� <br />r ����-" L,.- , <br />City <br />City <br />City <br />:j <br />State/Zip <br />State/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 have read and examined this application and know fhe same to be frue and <br />correct. All provisions of /aws and ordrnances governin� fhis fype of work will be complefed <br />whefher specified herein or not. The granting of a permrt does not presume to give authorify to <br />violafe or cance! the provisions of any other state or local law regulating construction or fhe <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 98.27 RCW and <br />296.200 WAC. , <br />� <br />re <br />Phone <br />Phone <br />Phone <br />FEE <br />�-_�lL' �--1� <br />