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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERE7i' PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />(u0[� �I� iv�.� <br />PROJECT ADDRESS <br />� <br />Owner <br />Tenant <br />Electricai Contractor <br />State License Number <br />er <br />S�K <br />Proposed Use of Building <br />Description of Work to Be Done: <br />Mail Address <br />Mail Address <br />S�G(,YVt-C- <br />City <br />City <br />City <br />NOTE: WIRING IN NON-DWELLINGS IS RE4�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />StalelZip <br />State/Zip <br />State/Zip <br />Conlrect Price of Work <br />Conlact Person (Plan Review) <br />FEE � �� <br />� <br />1 hereby ceAily fhat 1 have read and examined Ihis application and kno:v the sarne to 6e truo and � I���_D / 2 <br />correct. AIf provis�ons o( laws and ordinances goveming this type o( work will be comp/eted �] <br />whefher speafied herein or noL The granfing of a permd does not presume to give authonty to <br />viola(e.orcancelfhe provisionso(anyofherstateorlocallawregulatingconsfructionorfhe <br />pe�formance o/ construction. That I am authorized by the owner of fhis properly fo perform the <br />�rork !or wliich application is made and 1 compty �vith the Slate Contrac(ors Law 18.27 RC W and <br />296.200 WAC. <br />�rn� rNkut QdUrsi <br />Phone <br />Phone <br />Phone <br />�.efY12(� �P�`� <br />I <br />