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ELECTRICAL PERMIT i4PPLICATION <br />CITY OF EVERETT PERMIT SERVIC�S <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 - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />�l9 . �e��11 Pr, � �� �u, .�� 77, ��r <br />PROJECT ADDRESS <br />Chvner <br />Tenanl <br />Electrical Contractor <br />State License Number <br />/d�-� � i, <br />Mail Address <br />(�� '� <br />Mail Address <br />Proposed Use of Building <br />Description of Work to Be Done: <br />4 �i %/ <br />Mail Address <br />L� ��vir <br />City <br />Cily <br />Gry <br />-� <br />SWte2ip <br />State2ip <br />Stale2lp <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />� <br />Phone <br />Phone <br />Phone <br />NOTE: WIRING IN NON-DWELLINGS IS kE(]UIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. ��QD <br />/ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereGy certily that 1 have read and examined this application and know the same to be true and <br />correcL All provisions o/ laws and ordinances goveming fhis fype o( work will6e complefed <br />whether speci6ed herein or noL The granfing ol a permd does not presume fo give aufhonty to <br />violate or canc�l fhe provisions o/ any other sfate or local law regu/afing consWction or fhe <br />peAormance ol consWc6on. That I am authonzed by the owner o/ this property ro pedo��n the <br />work lor which applicafion is made and 1 comply witb the State Contractors Law 9827 RC W and <br />WA C. <br />� � <br />_0 5 0�� <br />��, <br />�-d <br />