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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�-1�-=� > <br />PROJECT ADDRESS <br />Tenant <br />Elechical Contractor <br />Mail Address <br />Mail Address <br />� P L <br />Mail Address <br />Stafe License tJumber <br />lir 5 i CI Pa-�(1 t� _ <br />Proposed Use of Building <br />Description of Work lo Be Done: L I �� � <br />^ ' ' <br />� � <br />�' / /� i� L�i./ � ,t 1' i� , � �. , t <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />1 <br />Cily <br />Ciry <br />City <br />7 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I here6y certily tl�af 1 have read and ex<vnined fhis applicafion and know the <br />correct. Al/ provisions o/la�vs and ordinances govemmg this type o/work w <br />whefher speal�ed herein or noL The granling o/ a pemut does not presume <br />violafe or cancel the provisions ol any other sfafe orlocal law regulafing cor <br />perfonnance ol construc(ion. That 1 am aathonzed by fhe owner of fhis proF <br />work lor whicN application is made and I comply wifh the State Con6actors I <br />29G.TA0 WAC. 1 A <br />� <br />rc7� r;�r� yZ3� <br />StatelZip <br />Stale2ip <br />State/Zip <br />Ccntract Frica cf N.'ork <br />Contacl Person (Plan Review) <br />r,„ .. ,..,... ; ���/` <br />FEE <br />, �� , p n <br />same to be true and <br />ill be completed <br />to give authonty to <br />struction or the <br />erty fo perlomi the <br />.aw 18.27RCW and <br />� �i/��C� <br />f�>���a-i3 `� <br />�'/oo <br />Phone <br />Phone <br />Phone <br />