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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.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� p <br />�� 1 ' Y�� �'L �. <br />i( i��v �� � � (' � � �: <br />PROJECT ADDRESS � <br />Owner <br />Tenanl <br />Eleclrical ConUacbr <br />Mail Address <br />Mail Address <br />Mail Address <br />I �,I �-(�( ) �5�1 �2,C��-i <br />Slale License Number <br />Proposed Use o( Building <br />f��,r o � <br />Description of Work �o Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AG CABLE. <br />State/Zip <br />Phone <br />City State2ip Ge�..,����oppn <br />��, �� L��kc 6 ' <br />�� `�s�� <br />City Slate/Zip Phone <br />- , <br />�� <br />C nUacl Price o( Work <br />�Qonlacl Person (Plan Review) <br />I �u U � �+- <br />� 1 ,. . n , �, <br />t:ITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily that I 4ave read and examined lhis application and Imo�v fhe same to be (ruo and <br />correct. All provisions of la�vs and or'dinances governmg this type o/ work will be conrpleted <br />�vhefher speci6ed he�ein ornoL The �ranfinr� of a pernut does nof preswne to give authorty fo <br />vinla(e or cancel the provisions of any ofher state or local la�v re�ulating construction or fho <br />perforrnance ol construc(ion. That I am a�dhorized by Ihe o�vner oI this property to peAurm fhe <br />work lor which application is made and 1 compty �vi!h (he Slate Contracfors La�v 18.27 RC W and <br />296.200 WAC.,� <br />/ � n _. _-- <br />FEE <br />UID�. ��� <br />