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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 i O 4 PM - DEBIT 8 CREDIT CARQS ARE NO7 ACCEPTED <br />33/(�� v�,-� <br />PROJECT ADDRL'SS <br />Owner <br />Tenant <br />Electrica� <br />State License Number <br />Pruposed Use of Building <br />Description of Work to Be Done: <br />e <br />Mail Address <br />Mail Address <br />Mail Address <br />�� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />I hereby certify thaf 1 have read and examined this <br />corcecf. All provisions oi laws and ordinances gov� <br />whether speci(ed herein �r noL The granting ol a <br />violate or cance/ the provisions ol any other state c <br />performance o/�onstruchon. 7hatlam authonzed <br />work lor which �pplication is made and 1 compty wi <br />City <br />City <br />CIty <br />e .�OD <br />State/Zlp <br />State2lp <br />State/Z(p <br />Contract Price of Work <br />Ccn:act Person (Plan Review) <br />ation and know the same to be true and <br />this type o( work wi/l be completeci <br />does not presume to give authority to <br />� law regulating construction or the <br />! owner of th�s property fo perform the <br />Stafe Contracrors Law 18.27 RCW and <br />�� � — .� "��� <br />Signaw•e Date <br />�asoz-��5 <br />FEE <br />Phone <br />Phone <br />Phone <br />�iGQ ;�w/ <br />