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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.everettwa.org <br />��ao-o� <br />Co�09-41 � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS AR� NOT ACC�PTED <br />�20 u�n�N <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Electrical Conlractor <br />����t-tezq�.3��r <br />State License Number <br />�Si��Jil li'l.� <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />I t�C . PU t3C� <br />Mail Address <br />Description of Work to Be Done: V� I Q� ��M �Dr � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIREG TO <br />BE IN RACEWAYS, N1C OR AC CABLE. <br />CITY OF EVERE7T LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />City <br />State/Zip <br />State/Zip <br />S�ate/Zip <br />Contract Price of Work <br />Phone <br />Phone <br />L �5�7)SR7 <br />Phone <br />Contact Person (Plan Review) <br />1 hereby certil� that I have read and examined;his application and know the same to be true and <br />correc!. All prcvisions ollaws and ordinances goveming this type of vork will be c�mpleted <br />whether specified hereir, or not. The granting o/ a permd does not presume to give authority to <br />violate or cancel the provisions o/ any other stafe or/ocal law regulating construction or fhe <br />peAormance o/ construction. That l am authonzed by the owner o( this property fo periorm the <br />work for which application is made and I comply with the State Contrac7ors Law 18.27 RCW and <br />296.200 WAC. <br />�1 <br />C% � j <br />FEE <br />ij <br />�� C %� j — � ci <br />