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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDNR STREET, [VERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — v�r.vw. ,verettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� Z� i� u� i V <br />PROJECT ADDRESS <br />Tenanl <br />vi n, c� <br />Mail Address <br />— O <br />A7ail Addiess <br />i 83l / y�; <br />Mail Address <br />/�� c,v�1 Q �-�3 '—C' <br />lalc License Numbcr <br />City <br />Ciry <br />I �� <br />City <br />State/Zip <br />SlatelZip <br />%�xSu���c ���- <br />SIatMZip <br />Conlracl Price ot Work <br />/, � � <br />Pro U�e o( tiuilding Contacl Person (Plan Revicw) <br />� <br />Phone <br />PhUI1C <br />IJOTE: WIRING IN NON-DWELLINGS IS REaUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />nereUy ceiiily Ihaf I have read and examineA fhis applicafion and know fhe same to be tn�e and <br />���nect. All provisions o! laws and ordinan�es govermng Ihis type ol �vork will be completed <br />�rhether speci6ed herein ornoL The granfinp ol a pennd does not �resmne lo yive authonty fo <br />violate or can:el tbe provisions o( any other slafe ur bcal law regulating constniction or fhe <br />pedormance o/ consfruc(ion. That 1 am aufhont^_d Ly fhe owner oI this preperiy to peAomi the <br />work Ior which applicalion is made and 1 comply wifh Ihe S(afe Confractors Lan- 78.27 RCW and <br />29G200 WAC. � <br />�-,��'�'�-, 8' 3- �� <br />FEE <br />5� ° J <br />