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ELECTRICAL PERM:T APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, C�GRETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />/ <br />.��� ` ,�� :� jJ �'r �� <br />PROJECT ADDRESS <br />Tenant <br />Mail Address � <br />City <br />Elecincal Conlractar Mail Address Cily <br />� ��� � �� <br />1 <br />ate Licensa Number <br />! .. �� ��� i�i ! 1 <br />Proposed U e o uilding� <br />Description of Work to Be Done: <br />Stale/Zip � PMne <br />.awio�uy ` Ph0118 <br />� � �C/� <br />Contrect Price of Work —�� <br />Conlact Person (Plan Review) <br />NOTE: WIRING IN NON•DWELLI�VGS IS REQUIRED TO <br />BE IN RACEW.''YS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />ry certi(y fhat 1 have read and examined fhis applicatron and krow the same to be tiue and <br />�rsp'ea ed herem or�noL nThe granti ey 9 a�ermrt �oesyPotp resume to give aufhon y to <br />ance of co�ns�ruction n That I ani aufho �ed 6y fhe�owne�o7fh�s property to pe�o�m the <br />�r�ry ich applrcation is matla and I complp with !he Srate Contractors Law 18.27 RCW and <br />CyWAC. _ <br />� <br />FEE <br />����/--�/ <br />.� <br />