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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 — ww�.everettwa.org <br />APPLICRTIONS ARE ACCEPTED FRQM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />��� 2� � �`P i'l (�-� � �i �%21'� l I <br />PROJECT ADDRESS <br />�-� �, f� L �e c� <br />Owner <br />Tenant <br />Elecirical <br />State License Number <br />Proposed Use o( Building <br />Description of Work lo Be Done: <br />Mail Address <br />Mail Address <br />Mail Address <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SAL[S TAX CODE IS 3105 <br />Cily <br />City <br />Ciry <br />� <br />�t�aiv-��s� <br />�= �e�6 <br />Slale/Zip <br />ao� <br />State/Zip <br />SWle2ip <br />Phone <br />Phone <br />Nhore <br />� <br />Contract Pnce oi Work <br />� ��_ _ � �2 l� <br />Contact Person (Plan Review) <br />1 hereby ceriily fhat I have read and examined this application and kno�v fhe same to be true and <br />conect. Al/ provisions ol laws and ordinances govermng this fype ol work will be completed <br />whelher specified herein or noL The granting o/ a permd does not presume to give aufhonty fo <br />violate or cancal fhe �rovisions ol any other sfate or local law regulafing construction or fhe <br />per(ormance o/ consfruction. Thaf I am aufhorized by (he owner o(fhis properly fo pedorm fhe <br />work Ior which application is made and 1 cornpty wifh the State Gontractors Law 18.27 RCW and <br />296.200 WAC. , <br />�✓�—� V ( �1.� <br />.F (y505- OSy <br />