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ELECTRICAL PE�MIT APPLI�ATION <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 />5>�� `� �����^���-- <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />Electrical Contractor <br />Rfa�a I ir.wnsr? Ni <br />Proposed Use of Buildinc� <br />Description o( Work to Be Done: <br />A1ail Address <br />A1ail Address <br />A1ail Address <br />, <br />r•�_ <br />NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERCTT LOCAL SALES TAX CODE IS 3105 <br />City <br />Cily <br />Cily <br />,u. <br />Stale2ip <br />State/Zip <br />State/Zip <br />Contracl Price o( Work <br />Conlact Person (Plan Review) <br />P�one <br />Phone <br />Phone <br />— _ /1't D ✓J �.�-�./Lc%� c—� <br />1 hereby certil}� thaf 1 have read and exarnined fhis application and know fhe same to be frue and <br />correct All provisions ollaws and ordinances g�veming this fype o(work wil/ be complefed <br />whefher specified he�ein or not The g�anting ol a pernnt docs nof resume to give authonty to <br />violate or cancel the I�rovisions oI any other state or local lau� reguPting constnicfion or the <br />perfonnance o/ consfruction. That 1 am aufhorized by the owner of Ihis property fo peAorm fhe <br />work lor wlrich application is made and I compl}� u-ith fhe S(ate ConVacfors Law 18.27 RCW and <br />296.200 WAC. _ <br />,�.� / / . <br />�/ l /.�? <br />FEE <br />— � - c_�� <br />� ;-•'�/ — �/ <br />i� . <br />