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ELECTRICAL PERMIT APPLICATION <br />I CITY OF EVERETT PERMIT SERVICES q� b�-05 <br />3200 CEDAR STREET, EVERETT, WA 98201 G O 5�����U <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />C l d 7 �.� vY ✓ i%/,.,; /� �,�;� ;-� t3 <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />/1�0 ✓%%+ �'i^ � <br />Electrical Contractor <br />State License Number <br />Proposed Use of Building <br />Tr ,��c/�; S '/ S <br />—� Mail Address <br />Maii Address <br />� ' <br />� < / � s��'� . % i" i . <br />Mail Adtlress <br />City <br />City <br />Ciry <br />Descriplion of Work to Be Done: �-t� i- < �% ��� �/UJ <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />{_ <br />SWte2ip <br />SlateRip <br />State/Zip <br />Contract Price of N/ork <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />I hereby certily thaf 1 have read ana examined this application and know the same to 6e frue anJ <br />correce All prowsions ol laws and ordinances goveming this type o/ work will be completed <br />whether specr6ed nere�n or noG T'he granting ol a permd does not presume to give authority to <br />violate or cancel the provisions o(any ofher sfa(e or local law regu/ating construcGon or the <br />peAorman:e o� consvuction. lhat I am authorized by the o�vner o/ thi; prope.7y to pedoim the <br />work lor �vhich application is made and I comply wrth the State Confractors Law 18.27 RCW and <br />- 296.200 WAC. <br />�� <br />:. , �, <br />� •� <br />FEE <br />5��1'! � <br />Phane <br />Phone <br />Phone <br />