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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 />�' / 1 r�' i, rl�, ��: <br />PROJECT ADDRESS <br />� , "�1��1 <br />Otvner <br />Tenant <br />Electrical Contractor <br />/ J_ <br />`' /�G /� ���` � `-� /��'vl <br />Mail Address <br />1 � � - :1-. <br />r�- � <br />Stale License Number <br />Proposed Use of Building <br />Descriplion of Work to Bc Done: <br />A4ail Address <br />MailA��.�• s <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 CODE IS 3105 <br />� <br />City <br />City <br />Cily <br />;�� j �%U � <br />, <br />State2ip Phone <br />Stale/Zip Phone <br />State2ip <br />Contracl Price of Work <br />Contact Person (Plan Review) <br />1 he�eby cedily fhat I have read and examined Ihis applicafion and kno�v Ihe same to be true and <br />correcf. All provisions o/lau�s and oidinances governm� fhrs type ol tt�ork will be completed <br />tvhether specdied herein or noL The granting o/ a pemut does nof presume to give aufhonty to <br />violate or cancel the provisions oI any other state or local law regulating construcUon or the <br />peilonnance o/ construc6on. That I am aufhorized by fhe owner of this p�operty to perform the <br />�vorA lor which application is made and 1 cornply with the Stafe Contraclors La�v 18.27 RCW and <br />296.200 WAC. <br />� � � � : <br />/ <br />,„_ �i-- .� "% li�, _ <br />Signawre Dale <br />FEE <br />Phone <br />�_ ��c� - � z � <br />