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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 3_ S�p�C <br />425-257-8&10 - FAX 425-257-8857 - www.everettwa.org <br />Cd�O 3�D2z <br />APPLICATIONS ARE .aCCEPTED FROM 8 AM TO 4 PM <br />���' 9 . ��' �� � � /i �✓ <br />, � <br />PROJECT ADDRESS , <br />� <br />Owner <br />Tenant <br />/��G <br />Electrical Contrectur <br />State ! icense N <br />Proposed Use of Buildinc� <br />Description of Work to Be Done: <br />Mail Addrzss <br />Mail Address <br />Address <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />City <br />City <br />Cily <br />StatelZip <br />StateiZip <br />StatelZip <br />Contracl Price of Work <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I here6y certify U�at 1 have rrad and examined Ihis applicaficn and know the sarne (o be true and <br />conect All provisions ollaws and ordinar,ces governmg Ihs t}�pe o( work �vill Ge completed <br />whether spea6ed herein or noL The �ranfin,q oI a pennd c!oes not presume fo give aufhorit}� to <br />violate or cancel fhe provisions oI any olher state or local �aw , Egulating consiructron or the <br />perlomiance o� construction. That 1 arn authorized by fhe owner oI this properiy lo per/orm fhe <br />work Ior which applica(ion is made and 1 compl}� with the Sfate Contracfors Lau� 18.27 RCW and <br />296.200 WAC. - -� (� <br />• /(���,� I/ ¢�- r, c1 <br />�' \�� I� v V _ �?-- �"' U I <br />Phone <br />Phone <br />Phane <br />FEE <br />-�7 � <br />��i� <br />j : G�.li); : �� �, <br />