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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEf2ETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE P�CCEPTED FROM 8 AM TO 4 PM <br />���� <br />�� ����,2C=� � �cV <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Eleclrical Conlraclor <br />State License Number <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />Ciry <br />City <br />MailAddr s � !1. �if"(/l� City <br />�7� �G�c��`,.-•a�n ti.e ,�2 <br />Descrip�ion of Work to Be Done: <br />�,� <br />� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />Stale2ip <br />Slate2ip <br />�v,� `t 6' 1l � 2�G <br />State2ip <br />Conlracl Price of Work <br />Contact Person (Plan Review) <br />�- D��� <br />CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily Ihat I have read and examined fhis applicafion and know the same to be frue and <br />conecf. All provisions o/ laws and ordinances goveming fhis lype of work will be completed <br />whefher specified herein or noL The g2nting ol a permd does not presume to give authonty to <br />violafe or canr.el Ihe provisions ol any other state or local law regulafing consWc6on or the <br />performance o/ consWchon. That ! am authonzed by the owner o/ fhis propeRy to peAomt fho <br />work lor which �ppficafion is made and 1 comply with fhe Slate Contractors Law 18.27 RCW and <br />�C/ � /b <br />FEE <br />L� <br />C05�o- a�15 <br />Phone <br />Phone <br />Phonc <br />