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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 />, <br />-�-�-�-- �.rn- ,.> O � V t. <br />PROJECT ADDRESS <br />Ovmer <br />Atldress <br />Cily <br />Stale2ip <br />J2S <br />Phone <br />b t� �3 /a \v� b n-�.NT J�- <br />Tenant A7ail AdAress City Slate2ip Phone <br />L � C �.f-�=: �.. � �.�- <br />Elec�rical CoNraclo� Mail Address City SlatelZip Phone <br />License Number <br />Proposed Use of Building <br />Description ol Work lo Bc Donc: <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 />� � � ( � �_� <br />Contracl Price of Work <br />H�Q-t ,i.lyaG,Y1J/l <br />Conlacl Person an Review) <br />1 hereby certily fhat I ha��e read and exarnined fhis application and kno�v the same fo be frue and <br />carrcct. All provisions ol laws and ordinances governing this type o! work will6e complefed <br />whether specilied herein or not The �ranfinn ol a pernut does not reswne to give aufhodty fo <br />violafe or canc�l the I�rovisions oI any ofher `sfale or local law regu�ting conslruc6on or the <br />per/onnance of cons��uction. That 1 a.r� authonzad by Ihe owner of fhis properly lo peAorm the <br />work /or which applicafion is made end I comply with fhe Sfafe Confractors Law 18.27 RCW and <br />29G200 WAC. <br />� � , � ,�� k,�-,��- � - � � - �� <br />`Signalu�2 �: Date <br />FEE <br />