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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everett at.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Owner Mall Address vv <br />City Slale0p Phone <br />Tenant Mall Address <br />City StateZP Phone <br />Contractor Mall Address City State/Zip Phone <br />tl4n0E9- 978M4' <br />State License Number '— <br />Propoossed Use of Building <br />Description of Work to Be Done: <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 />I hereby certify that l have read and examined this applle <br />correct. All provisions of laws and ordinances governing <br />whether specified herein or not. The granting of a permit <br />violate or cancel'the provisions of any other state or local <br />performance of construction. That I am authorized by the <br />work for which application Is made and I comply with the <br />290.200 WAC, <br />��- <br />Contract Price of Work <br />Contact Person (Plan Review) <br />'I_, n_/. <br />FEE <br />Ime to be the and �' 0 —I —C9 ( 3 <br />5e completed <br />portion or i ey to <br />Y to perform the <br />v 18.27 RCW and <br />100."1(l)in 311110313 TIHN'HVA Of:S LUCCSZt SYa 05:11 0107✓40/fO <br />