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ELECTRICAL PERIIAIT APPLICATiON <br />CITY OF EVERETT PERMIT SEFtVI�ES �� r�� <br />3200 CEDAR STREET, EVERETf, WA 98201 ��- <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� I I Og�-I 1 Z <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />90q SS� �vP r��iLl �J lJA +� � f;- I ZU <br />PROJECT ADDRESS <br />Owner <br />Electrical Contra�tor <br />Mail Address <br />Address <br />Mail Address <br />�-��s�,r%fs'90<�S <br />State License Number <br />n���,LP -+ lcr;�►��a%�n � <br />Proposed Use of Building <br />Description of Work to Be Done: <br />NOTE: WIRIFiG IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVI_RETT LOCAL SALES TAX CODE IS 3105 <br />1 here6Y ceifi/y that I have read <br />correct. All pruvisions o/laws � <br />whetherspeci(red herein ornot. <br />violate or cance7 fhe provisions <br />performance o(construction. T <br />work for which applicaGgn is «�. <br />296.200 WAC. ��:-� ! � <br />, <br />I <br />City <br />City <br />State2ip <br />��c�ff� w/� 9�'� <br />State2ip <br />��9�a,o� <br />Contract Price of Work <br />Contad Person (Plan Review) <br />this application and know the same to be true and <br />goveming this type al work will be complefed <br />�/ a permd dces not pfeswne to give authority to <br />�te orlocallaw 2gulating constn�chon orfhe <br />ized by the owner ol this �ropeRy to peAorm the <br />iv with tlie S�ate Confrdctors Law 18.27 RCW arJ <br />Phone <br />H1S- � <br />FEE <br />I ��� � � <br />Phone <br />Phone <br />���'�_.<<�- <br />