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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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />���� '!�✓2�/cC�25� �/, <br />PROJECT ADDRESS <br />�fle l ���/� s <br />oW�e� <br />Tenant <br />�� � <br />ElecMcal Contractor <br />State License Number <br />Proposed Use of Building <br />Description of Work to Be Done: <br />.s�Sh�P.t� , `�� <br />.�,�vi.e � <br />Mail Address Ciry <br />Mai� Address ��ry <br />Mail Address <br />�� Q <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETi LOCAL SALES TAX CODE IS 3105 <br />City <br />�/ <br />!ti� ��d I _ <br />State2ip Phone <br />State/Zip Phone <br />Stale2ip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />FEE <br />I here6y ceRi/y that I have read and examined this application and know the same to be frue and <br />correct. All provisions ollaws and ordinances goveming th�s type ol work will be completed <br />whether speci�ed herein or noG The granting uf a permrt does notp resume to give authonfy to <br />vio/ate or cancel the provisions o/ any othe� state or local /aw regulating construction or the <br />peAormance o) construction. That I am authonzed by the owner ol th�s property to per/orm the <br />work for which appliwtion is made and 1 comply wdh the State Confractors Law 18.27 RCW and <br />296.200,rVAC. <br />t � � �A <br />F GS�L �z� <br />Phone <br />