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ELE�TRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERNiIT 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 />��� Z� ��(1CP Nvo� (.(7/1 �� -- <br />PROJECT ADDRESS � <br />T <br />Electrical <br />�—� N <br />Mail Addres�s <br />� z.s <br />, <br />Mail Address <br />S�} l��v <br />MaA nd� <br />�P,E° ;N� v�l1)l' !T �[�Z <br />State LicenseJ umber <br />f� i�n� f��r� �c>2r-� <br />Propased Use of Building <br />Descriplion of Work to Be Done: <br />� �(,���.� � (� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN R.4CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Ciry ' State/Zip <br />„_ �� _o�� �.��- � <br />ity Stale/Zip <br />�An:u�� �G� fr/Pad�- G1 <br />Ci�y <br />State2ip <br />Contract Price of Work <br />�I7� r i-P � Y_.,/�� <br />Contact Person (Plan Review) <br />/ hereby cerii(y (hat I have read and examined fhis applica(ion and kno�v (he same to be true and <br />correcl. All provisions ollaws and ordinances governmg (his type ol �vork �vill be completed <br />whethei specdied herein or noL Tbe granfing o/ a permd does not res�une io give aufhoiity to <br />violate or cancel (he provisions ol any other state or local law reguP(ing eonstruchon or the <br />perfomrance ol conslruction. That I am aulho�ized by the owner ol this propeRy to peAorm the <br />work lor �vhich application is ntade and 1 compty �vilh !he Sfate Conlracfors La�v 18.27 RCW and <br />296200 WAC. <br />FEE <br />Phone <br />Phone <br />Plione <br />/ <br />��� � / �/�� <br />