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EL�CTRICAL PERMIi APPLICAiI�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT,'J��A 98201 <br />425-257-88 i0 - FAX 425-257-8857 -ww�.everettwa.org <br />APPI.!.^•ATIONS kRE ACCEPTED FROf�i 8 AM TO 4 PM <br />i <br />i �O � �', `L-r � ] � - �— <br />!=ROJECT ADDRESS <br />. ,.,i /)I�I ' . <br />�I Cwner !dail Address ���Y <br />Tenant <br />Mail Addmss <br />City <br />St3te(Zip <br />3tate2ip <br />Phone �I <br />Phone I <br />, - �l . r, !i. _ i �.�!- %c. —. <br />I <br />clecVical Contractor Mail Address City State/Zip Phone <br />''-1L.b;T!. :�i- .;,i i. �, - _ <br />State License Number <br />Proposed Use of Building <br />Dzscriptlon of WcrK to Be Done: � -- <br />�IUTE: WIRING IN NON-DWELLINGS IS REQUIRED T(� <br />BE IN RACEWAYS, MC OR AC CABLE. <br />Contract Pnce of Work <br />Ccntact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />i h�reby certily thaf 1 heve read 2nd examined fhis epplication and know the same !o be true and <br />correct FJI promsions ollaws and ordinances goveming this type of �vork wrll be completed <br />��.h=(her specified herein or noL Thz grenting of a pertnd does not presume fo give authonty fo <br />crolate or cancel C= provisiuns of any other state or localleiv regulatmg constrvction or the <br />peAormance ol construchort That 1 am authonzed by fhe o�vner o; fhis pmperty fo pedomi fhe <br />v: ork �or which appli=afion is made and I comply wifh the State Confrectors Law 18.27 RCW and <br />29"0200 WAC- <br />� <br />FEE <br />