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. <br />, <br />� <br />ELECTRICAL PERNlIT 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 />" I� �G U U.AQ II (/ r <br />PROJECT ADDRESS <br />Te�iant <br />'L D�] <br />Mail Adtlress <br />A4ail Address <br />, <br />, <br />S c< <�� 7 <br />Eleclrical Conlraclor Mail Address <br />C' 1 a��� F�,j o�`�/r� <br />Stat� License Num6er <br />� ���/ �� <br />ri' opa�ed Use ol Building <br />Descriplion ol Work �o Be Dona �� J• <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />StatelZip <br />Slate/Zip <br />� <br />StatelZip <br />Phone <br />Phone <br />/ )_ ��i <br />�.�_ <br />/��1�z �� <br />� �l!� <br />ontract Price o( Work <br />Contact Person (Plan Review) <br />1 hereby certify that I hnve �cad and exanuned fhis application and know the same to be true and <br />conecL All provisions olla�vs and ordinances governmg (his type ol wurk �sill Ge complefed <br />wbefher specilied herein or noL The granfing o/a pernut does not resume to give authonty to <br />violate or cancel the provisions ol any other state or local la�v reguPfing cansfrucGon or fhe <br />perforni,ince ol constiuc(ion. Thaf 1 am authorized by the owner o/ fhis properly fo per/orm the <br />�voik lor �shich application is made and I comply �vith the State Confractors La�v IQ.27 RCW and <br />29G 200 IVAC. <br />� _� _��-,� �. <br />FEE <br />i? <br />,, �� /�' <br />. � �.- <br />