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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 B AM TO 4 PM <br />�a� �.�wT�v��N� sr <br />PROJECT ADDRESS <br />�� <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />Electrical Conlraclor Mai� Address <br />�' ��S`1' / 5`Z <P _ <br />Slate License Number <br />��/` <br />Proposed Use of Building <br />City <br />Clty <br />City <br />Descriplion oi Work lo Bc Done: ����%��lY ��� �(�/ !� <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 3705 <br />SWte21p <br />State2ip <br />�/ <br />SlatelZip <br />(, ��6-06 <br />t>06ob-��y <br />S��s <br />.�'3 <br />i 33 � <br />Phone <br />��� Phone <br />�� <br />Phone <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />1 hereby certily tliaf I have read and examined this applicafion and knnw the same to be frue and <br />correct. All provisions o( laws and ordinances goveming this fype of work will be complefed <br />whefher spec�(ed herein or not The granfing o/ a pemut does not presume fo give authonty fo <br />violale or cancel Uie provisions olany ofher state or local law regulafing consfn�ction or fhe <br />perfomiance o/ conslruction. That I am aufhonzed by fhe owner of this property to peAorm the <br />wo�k lor which application is made and 1 cornply with the State Contrac(ors Law 18.27 RC W and <br />FEE <br />��66 <br />r0(vd6-(12 <br />