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�LECT'RICAL P�RM�T APPLICATION <br />�ITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRrFT, EVERETT, WA 98201 <br />425-257-8810 - Ff1X 425-257-8857 — www.everettwa.org <br />APPLICATI( �NS ARE ACCEPTED FROM 8 HM TO 4 PM <br />� !' � �� �-r- - <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />Eleclri^al Contrector <br />Slale License Number <br />Prupesed Use of BuilJing <br />Description o( Work to Be Done: <br />Mail Address <br />A1ail Nddress <br />Mail Address <br />NOTC: WIRING IN NON-GWCLLINGS IS REQUIRED "f0 <br />BE IN RACEWAYS, A1C OR AC CABLE. <br />CITY OF [VERETT LOCAL SALES TAX CODE IS 3105 <br />Cily <br />City <br />Cil � <br />Slate2ip <br />StatelZip <br />SlatelZip <br />Contracl Price ef l4�ork <br />Conlact Perscn (Plan Review� <br />1 hereby ce:tilv fhaf I have read ond exarnined lhis application and kno�+� the same to Ue tnie and <br />correcL Ail provisions oI la�vs and ordinances governing th!s type o/ work will be cornpleted <br />whetherspecdied herein ornoL The c�ranfing o(a pe�mR does nof restune'o gi��e aufhonf}� to <br />violate or cancel the �iucisions oI an}� ofl�er state or local la�v re�uPting construcfion or fhe <br />pe�fomiance o/cons�ivcfion. That 1 arn aufhorized, by fhe ou�ner o/ this property to perfenn the <br />i.vork (cr which applicafion is mado and I comply wrth fhe Sfafe Contracfors La�,� 18.27 P,CW and <br />196.200 WAC. " <br />� ,� /. <br />� <br />�i ,.1.:�,�c.. �- ' l'�j%Y'; <br />I; r�. C-`- � <br />I S��{7naWre Dak <br />;' 1 <br />F[E <br />� �; "1LGi— �lG� <br />FhUne <br />Phorc <br />Phone <br />