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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 />2J <br />PROJECT ADDRESS <br />Owner Mail Address <br />/�'�1����j�r�� �"�fG'Q31/�'�a"✓ <br />Tenant <br />Electrical Coniraclor <br />Stale Licenso Number <br />Proposed Use ot <br />Descriplion ol Work to De Done: <br />Mail Address <br />I.tail Address <br />- ��-�� <br />UZ �G�s-��' �,I <br />Cily <br />( <br />Cily <br />City <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />� ✓? <br />s� ��� ��, <"�'� �, <br />S�ate2ip <br />S�ale/Zip <br />Contracl Price of Work <br />ContactPerson (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify fhaf I have read and exanr'ned fhis applicafion and know the same fo be We and <br />correcL All provisions ollaws ar�d ordinanct-s govemmg lhis type ol work will be comp/efed <br />�rhefher specibed herein or noL �he granfing oI a permd dees nof presume to give aufhonry fo <br />v;olate or cancd the provisions ol any ofher stale or local law regu/ating construction or fh.e <br />perlormance o/ consfruchon. Thaf I arn aufhonzed by the o�rner ol this property to perlomi fhe <br />work 1or which appli ation is mado and 1�mply with the Sfale Confractors Law 18 27 RCW and <br />29G.200 WA %�j / • ; <br />i <br />� � i ^ . z . <br />FEE <br />C Glc1�—CLL �J <br />Phone <br />Phone <br />Phone <br />