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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETi', WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� r�C w r��« I« I�-��, �?`�� � <br />PROJECT ADDRESS <br />�2 Cr� :-� <br />d l,l� i'� � i," <br />Eledrical Conlractor Mail Address <br />Slate Licenso Number <br />Proposed Use of Building <br />Description of Work to Oc Dono: <br />NOTE: WIRIIJG IN NON-DWELLINGS IS REQUIREU TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l�J� �z�s <br />Conlracl Prico of Work <br />Canlacl Person (Plan Review) <br />I hereby certi/y thaf ! have read and ex�mined fhis applicntion and know fhe same fo 6e true and <br />correct. All provisions ollaws anA ordinances govmnmg fhis fyUe ol ivo�k will be complefed <br />whether speci�ed herein or noL The gi.�nting oI a permrt does nof presume to give authonf}� to <br />violate or cancel fhe provisions olany ofher sta(e orlocalla�v regulatin� consfrudion or fhe <br />perlonnance o/ consfruction. That I am autho�ized by fhe owner of fhis property fo perfonn the <br />aork lor uhich applicafion is made and 1 compl}� wi(h the Sfafe Confracfors Law 18.27 RCLN and <br />298.200 INAC. <br />�. ` �:�'��_ � ���,�.� ��/;%��,. � <br />FEE <br />' <br />(_0�U -r_�;`� <br />