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ELECTRICAL PERIIAIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everethva.org <br />APPLICATIONS ARE ACCEPTED FkOM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />�7U.� �i(�� iM/J2(T �C� <br />PROJECT ADDRESS <br />oW�e� <br />Tenant <br />;�� <br />Mail Address <br />Mail ACdress <br />Electrical ConUactOr Mail Address <br />�c �-"�s-��,'�-�'G� <br />State License Number <br />��tOes,1'%,�t <br />Proposed Use of Buiiding <br />Ciry <br />Clry <br />City <br />Slate2ip <br />Slate2ip <br />LG��%j � ��, <br />Pnone <br />Phona <br />State/Zip c„�` s� onye <br />z�� Xf� �9 3 <br />Contract P�f Work <br />Ni <br />Contact Person (Plan Review) <br />NOTE: WIRING IN NON-DN'cLLINGS IS REQUIRED TO <br />BE IN RACEWAYS MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certi(y fhat I have read and examined fhis app/ication and know the same to be lrue and <br />correcL PI/ provisions o/ laws and ordinances goveming this type ol work will be completed <br />whether speci(ed herein or not The granting o) a permR does not presume to give authonty to <br />violate or cance/ the pro�-isions ol any other state or local law reguleting construction or the <br />performance o/ construcfion. That I am authonzed by the owner of this property to peAorm the <br />work lor which app/ication is made and 1 comp/y with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />F U � i�� ����� <br />