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EL�CT'RICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org 3_a3-�i <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM Cl/D 3—��� <br />I913 ���rsr�X fi've <br />PROJECT ADDRESS <br />S+�� <br />Owner <br />Tenanl <br />St�te Licens� Number <br />Proposed Use of Buildin� <br />Mail Address <br />Mail Address <br />Mail Address <br />Cily <br />Ciry <br />City <br />Description o( Work lo De Done: ��'f'G�'lf � YGvYI O(�.� <br />NOTE: WIRING IN NON-DWELLINGS IS RtQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily fhat 1 have read nnd exarnined fhis applica(ion end know the sa� <br />correcL FlII provisions o(laws and ordinances governing this type oI work wi116 <br />whe(her specified herein or noL The c�ranting o( a pennd does not presumo to � <br />i�iolate or cancel the provisions ol any other sta1A er local la�v regulating constn <br />peAormance ol consVucfion. Thaf 1 am aufho�ized by the owner ol this propert) <br />�vork Ior which applicafion is made and 1 comply wifh fhe Stafe Contractors LA�a <br />296.200 WAC. <br />/5G' i �1 r-� <br />Stale2lp <br />State/Zip <br />State2ip <br />� �QDo°� <br />Controct Price of Work <br />Conlact Person (Plan Review) <br />� to be frue and <br />completed <br />ve authonty to <br />tion or the <br />'o pedumi the <br />8.27 RCW and <br />FEE <br />�1117�� �3`I <br />Phone <br />Phone <br />: 3'�' <br />Phone <br />