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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.evereriwa.org <br />APPLICATIONS ARE ACCEPTFD FROM 8 AM TO 4 P1A - DEBIT 8, CREDIT CARDS ARE NOT ACCEPTED <br />v7 / / � [ U l-r�i✓G� <br />PROJECT ADDRESS <br />.S f <br />Owner <br />Tenant <br />K� � <br />ElecVical Contractor <br />State License Number <br />Proposed Use of Building <br />Description of Work ta Be Done: <br />3// � <br />Mall Address <br />Mail Address <br />Mail Address <br />I I� <br />d c!� ft/ <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 />City <br />ciry <br />City <br />u <br />� � <br />State2ip <br />State/Lp <br />State2lp <br />Con!ract Price of Work <br />Contact Person (Plan Review) <br />I here6y ceriily that I have read and examined this applicaUon and know fhe same to be tnre and <br />correct. All provisions ollaws and ordinances goveming this type ol work wlll ba comp/eted <br />whether specifiea herein or not. The grenfing o/ a permit does not presumo to give authority to <br />violate or carcel the provisions ol any other state or local law regulating constnicfion or tha <br />wor�i�c lo wh ch appl cation s ade and I comply w th fhe State Confrhs�cPrspLaw 18.2 RCW and <br />296.200 WAC. <br />�� ���� � �/� <br />tic^�L V 1i�� L/-� S ^�/%� / <br />r.� <br />J C� <br />FEE <br />�/3 <br />Phone <br />Phone <br />Phone <br />