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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 I'— g—D� <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org ��'����� <br />APPLICATIONS ARE ACCEPTEO FROM 8 AM TO 4 PM <br />.;� �� l�� f0'r� �d� .�✓�f�ff"�li/�i ��jli/ <br />PROJECT ADDRESS <br />� <br />owne� <br />Tenant <br />�//a,•-r 2���fi'", <br />Electrical Conlraclor <br />Afail Adtlress <br />A1ail Address <br />. i/0/J,,. <br />City <br />Mail Address Ciry � <br />� ��i,t�,'��s�l �k "_ � 1 � �'� <br />State License Number <br />/�� <br />Proposed Usc of Building <br />Descrip�ion af Work to De Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />B[ IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Slatc/Zip <br />Slate2ip <br />(��i�'��� lr/ <br />State/Zip <br />Phonc <br />Phone <br />f���3�8/� <br />Phone <br />���L�/ J� <br />CoMract Price of Work <br />Contact Person (Plan Review) <br />�� <br />I hereby certity Ih��t I lmve read t�nd exarnineAthis applicafion and kno�v Il�e same fo be fnie and <br />conecf. All provisions o� /aws and ordin�nces �overnmg fhis f}�pe ol work will be comp?eted <br />whefher specJied hcrein or noL The granting ol a pernvl does not presurne to �ive authonty to <br />violnte or cancel the provisions olany other state or loc�llaw regulatinc� construcfion or fhe <br />pedonnance oI construc(ion. Thnf 1 am aulhorized by the o�vner o! fh�s property to peAorrn the <br />work Ior which applicafion is made and 1 compty with the State Confracrors Lnw 18.27 RCW and <br />296.200 WAC. <br />FEE <br />� <br />� J � 7 <br />/- �,. G� �, <br />�,� �� i - �� > <br />Si�nature Date !— <br />L-- <. <br />