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ELECTRICAL P�RMfT APPLlGATIG'N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETi, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS P.RF NOT ACCEPTED <br />� � � � y� <br />PROJECT ADDRESS <br />Owner // <br />�-� <br />i,.�� <br />Tenant <br />Electrical Contractor <br />G,/�s� , zye� /�� <br />Mail�Address <br />5�� // � <br />Mail Address <br />Mail Address <br />State License Number <br />� <br />5,/ , <br />Proposed Use of Bwlding <br />Description of Work ta 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 />U zs^- 3 3 � ��s3� <br />�✓.�,-��f c�/� ��'�' � <br />City <br />City <br />SfateniP <br />Stale2ip <br />State/Zip <br />� <br />Contract Price of Work <br />Contact Person (P�an Review) <br />d�S <br />I hereby ceRify that I have read and examined this application and know fhe same to be We and <br />correct. All provisions of /aws and ordinances govermng this type of work will be completed <br />whettrer specified herein or not. The grenting of a pe�md does not presume fo give aufhonty to <br />violate or cancel the provisions ol any other sfate or loca/ law regulating ce„sfruction or the <br />pedormance of construchon. That / am authorized by fhe owner of thrs propr,Ry to Ferlorm the <br />work (o� which application is made and I comply with the State Contractcrs Law 18.27 RCV✓ and <br />296.200 WAC. <br />,, . <br />, t .:,, <br />�. , <br />��:,;- _ � �. _._ �. <br />3 r� S� <br />�c6a- r�l�f <br />� <br />FEE <br />rhone <br />Phane <br />Phone <br />