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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREEI , EVERETT, WA 98201 <br />425-257-8810 - FA�C 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE hOT ACCEPTEU <br />ioD�i S-� aG( fi�1�,..� S��l <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />. Q <br />n�tAe.�n i u .v�'taa.,. �%� <br />Mail Address <br />���� <br />Mail Address <br />� 11.��2r:l�tflL `��% ('(IJ <br />E�ectrical Contractor Mail Address <br />�C��t r �r-�-� o� 6 J �. <br />State License Number <br />CC�S"two <br />Proposed Use of Building <br />Description of Work to Be Done: <br />PlOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />! hereby certify that I have read and examined this applic <br />correct. All provisions o1la�vs and ordinances governing <br />whether specil�ed herein or not. The granting o( a permit <br />violate or cancel tne provisions o(any other sfate or local <br />performance of construc6on. That 1 am auGionzed by fhe <br />work lor which application is made and I comply evi:h the <br />296.200 WAC. <br />City <br />Ciry <br />City <br />and know the <br />�pe ol wark w <br />� <br />Stale/Zip <br />Slale/Zip <br />State/Zip <br />� �000 � <br />Cont act Price of Work <br />Contact Person (Plan Review) <br />.�. , w� ire 3 NrlR� <br />s to be true and <br />completed <br />�e authonty to <br />!ion or the <br />o peAorm the <br />8.27 RCW and <br />FEE <br />Phone <br />Phone <br />Phone <br />