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ELECTRICAL RERMIT APPLICATION <br />CITY OF EVERETT PERMIi SERVICES <br />3200 CEDAR STREET, EVEP.ETT, WA 98201 <br />;25-257-8810 - FAX 425-257-8857 — wwv✓.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />ci O`l 5. E� E U c� e`�' /y� a � � �ti� a 1/ <br />PROJECT ADDRESS <br />Gwner Mail Address Ciry <br />State/Zip <br />Phone <br />Q � o i� Q <br />Tenant Mail Address City State/Zip Phor�e <br />/�'iu?4�' �;I� �..4Y(EU�io6i�' I�1-�UI`� 1�or1 /�iill ���� Z l�o � <br />Eleclrical Conlractor Mail Address City Slate/Zip Phone <br />,�l �, z 4 I� �� oi ��T <br />State License Number <br />Proposed Use of Building <br />Description of Work to Be Done: �� 7�� I� <br />� nl,f�5 aut� i �a�A II <br />NOTE: 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 />Coniract Price of Work <br />Conlact Person (Plan Review) <br />1 hereby certify thal I have read and examined fhis application and know fhe sam: fo 6e true and <br />conecf. All provisions o/laws and ordinances goveming this type ol work will be completed <br />whe(her spec�6ed herein or not The granting o/ a pec�uf does not presume (o give aufhority to <br />violate or cancel the �rovisions ol any ofher state or local Imv regulating construcfion or fhe <br />perlormance oI consfruction. That 1 am authorized by Ine owner o/ fhis property to per/orm fhe <br />work Ior which applicafion is made and 1 compty �vifh (he State Con(racturs L�w 1827 RCW and <br />296200 WAC. <br />FEE <br />� <br />�G(�US -/� % <br />