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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />- .�� %I / �G'r���-l' <br />PROJECT ADDRESS <br />Tenant <br />Electrical Conlrector <br />State License Number <br />Proposed Use oi Building <br />ti�; �� <br />Mail Addross <br />Mail Address <br />A1aii Address <br />Description of Work to �e Done: <br />�, � �iL. C -. �(i( � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />�� C/��G � <br />Cily State2lp <br />Cily State2lp <br />City Stale/Zip <br />Conlract Price oi Work <br />Contact Person (Plan Review) <br />_ �, � 3 �',�,, <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />! hereby ceriily thaf 1 have read and examined fhis applicafion and know the same to be true and <br />correct. A/l provisions o//aws and o�dinances goveming this (ype oI work a�ill be complefed <br />whether spea�ed herein or not Th� granting o/ a permrt does not presume fo give authonty to <br />viola(e or cancel Ihe provisions oI any other state or local law regulafing construction or the <br />perfonnance o/ cons�nicfion. Thaf 1 am aufhonzed by fhe o�rner o/ fhis property to peAorm fhe <br />work /or which application is made and I comply with fhe Sfate Contractors Law 18.27 RCW and <br />e <br />" -'� �) '- �l <br />FEE <br />> <br />Phone <br />Phone <br />Phone <br />. W� <br />� \ <br />O�D <br />V <br />