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ELECTRICAL PERMIT APPLICATlON <br />CITY OF EVERETT PERMIT SERVICES <br />T EVERETT WA 98201 <br />3200 GEDAR STREE <br />425-257-8810 - FAX425-257-8857—www•everettwa.org �j—��—�� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ����3"�%� <br />� �l �1 �G���� �11 w'l �� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />M11ail Address <br />l�� C�% <br />Mail Address <br />L / ��Z �i <br />Mail Addmss <br />n�1�1/�� �:�<<,� � rf� _ <br />Stale License Number <br />Proposed Use ol Duildin9 <br />Descriplion ol Work lo Bc Done: <br />NOT�: WIRING IN NON-DWELLINGS IS R[QUIRED TO <br />[iE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certity fhaf 1 have read nnd examim <br />eonecf. All provisions ollaws and ordinmici <br />whelher speci(icd herein or not. The g�anfir <br />violate or cancel fhe piovisions o( any other <br />performance a! constiucl�on. Tliaf I ar» aull <br />work for �vhich application is made and I coi <br />296.200 WAG j' <br />' ,��'�:;��' '-��/%' <br />Ci1y <br />Cily <br />City <br />S�a�e2ip <br />StatelZip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Ihis applicafion and kno�+• ?he sarne lo be true and <br />governmc� Ihis lype ol work will be complefed <br />3fe or locatl��v reguPf nq�cons�r9cll on or�flie to <br />ized by the o�vner o/ this property fo peAorrn tlie <br />ly �rilh thc State Confractors La�v 7827 RCW and <br />.� l���C��O <br />FEE <br />�� _ <br />Phonc <br />Phone <br />Phone <br />�=����- 70 <br />