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ELECTRICAL E���MIT APPLICATION <br />CITY OF EVERETT �ERMIT SERVICES <br />3200 CEDAR STREET, EVEFiETi, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�7�5 ���( �u ll �,� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />� <br />Eleclrical nh <br />�c���i��9�l�r <br />Slale ' e se Number <br />L C "!'Y%i��'�!Q � <br />Proposed Use of Building <br />Descripfion oF Work lo Oo Done: <br />Mail Address <br />Mail Address <br />Mail Address <br />�v � <br />City <br />� <br />City <br />� <br />��YGLe(� . � <br />City <br />NOTE: W IRING 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 />Stale2ip <br />Phone <br />L(l/¢ _ <br />Slale/Zip Phone <br />h>9- <br />Stale2ip <br />�� <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I heroby certi(y fhat I have read and examined fhls application and know ihe same fo bo (rue and <br />correcl. All provisions o( la�vs and ordinances goveming this (ype of �vork will be completed <br />whether specified herein or noL The granfing ct a pennit does nof presume to give authonty to <br />violafe or cancel lhe provisions of any olherstate orlocallaw re�ulating construcfion or fhe <br />per(omiance o(cons(ructron. That 1 am aufhonzed Ly thi� owner of this property fo perform fhe <br />work (or which application is made and 1 comply viilh the State Contractors Law 18.27 RC4V and <br />296.200 WAC. / . <br />Phone <br />FEE <br />EJ l C(� OS ��- <br />� <br />