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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <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 />'' ( � � �n�'i�X�l �l/J� ��'Pit-Pi✓ � � <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Electrical Cantrecror <br />State License Number <br />S�R <br />Proposed Use af Building <br />Description ot Work to Be Done: <br />Poa�'` <br />,�. <br />Mail Address <br />Mail AdCress <br />Mail Address <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />City <br />City <br />Ciry <br />��u z� � �(�- <br />SlatelZip <br />StatelZip <br />Slate/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions ol/aws and ordinances govemmg this type o/ work will be completed <br />whefher speci��ed herein or not. ihe granfing o/ a permrt does ncf presume to give authodty fo <br />violate or cancel the provisrons o/ any other state or /ocal law regu/ating construction or the <br />peAormance o/ construchon. That I am authonzed by the owner of this property to pedorm fhe <br />work /or which application is made and 1 comply with the State ConVactors Law 18.27 RCW and <br />�Z <br />Phone <br />Phone <br />Phone <br />FEE <br />3.s' °.� <br />E�5�z-� �l � <br />