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�LECTRICAL PERII�IT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES g.-3i..11 � <br />3200 CEDAR STREET, EVERETT, WA 98201 g �"O d`�b <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.or o <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />'��3 �dZ l✓�.../��51`fu !'��rd, ��,Q 82oi <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />i��/ii M�� 7 7' a,�� <br />S�tale Ucense Number <br />Proposed Use of Building <br />Description of Work to Bo Dono: <br />Mail Address <br />Mail Address <br />Mail Address <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />City <br />City <br />City <br />Stale/7Jp <br />Stale2ip <br />w44+4 <br />State2ip <br />I(/V� <br />Cnnlra^.t Pr�ce of Work <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />! hereby certify that I fiavo read nnd exemined fhis application and know the sane to be true and <br />correct. All provisions o(laws and ordinances goveming this type ol work will6e completed <br />whether specified herein or not The granting ot a permd does not presume to give authonty fo <br />violate or cance/ fhe provisions oI any other sfate or local law regulafing construction or the <br />perlomiance o! construcfion Thaf 1 am authonzed 6y the owner o/ this property to perfortn fhe <br />work (or which application is made and 1 comply wifh the Sfate Contractors La�v 18.27 RCW and <br />296.200 WAC. <br />� �r�G.� f'V�1 <br />FEE <br />��lUa - l t9� <br />Phone <br />Phone <br />Phone <br />