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ELECTRICAL. PERI�IIIT ApPLICATION <br />CITY OF EWERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 325-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FR0�7 8 AM TO 4 PM <br />2_3ri 4�i�G��� � <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />Eiedrical Contreclor <br />State Licenso Number <br />Proposed Use af Building <br />Description oF Work to Be Dono: <br />Mall Address <br />Mail Address <br />Mail Address <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIkED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Cily <br />Cily <br />City <br />State/Zip <br />Stalcrzip <br />Stale2ip <br />� -- S -�� <br />�-0 60 �_007 <br />Conlract Price o( Work <br />Contact Person (Plan Reviow) <br />1 hereby certi(y fhaf 1 have read and examined this application and kno�v (he sarne fo be fn�e and <br />correct All provisions cllaws and ordinances governm� this type ol work wil( be compleled <br />whe(her specified herein or noL The granting o/a pemut does not presume fo give aufhonty to <br />violate or cancel fhe provisions ol any other state or /ocal law regu/ating construction or the <br />perfornwnce o! constn�chon. Thaf I am authonzed b� the owner of this propedy fo perforrn the <br />�wrk (or �vhich application is rnade and 1 comply with the Sfate Contrac(ors Law 18.27 RCW and <br />296.200 WAC. <br />XI/ ' U.ii��"'N^I"'l/ �-- <br />FEE <br />�C'�7-�Ci7 <br />Phone <br />Phone <br />Phone <br />