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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 , <br />425-257-8610 - FAX 425-257-8857 — www.everettwa.org ' <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />q3_ � �����,J �% <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Electrical Conhactor <br />q33 <br />MailAdOress <br />Mail Address <br />:i C Q <br />Mail Address <br />�o,Q�S,�o zy cS <br />State License Number <br />�riA-c��d ��4G.� <br />Proposed Use of Building <br />Descriplion of Work lo Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />Cdy <br />City <br />StatelZip <br />State2ip <br />State2ip <br />�S3Z� sn� <br />Phone <br />Phone <br />��SL3-7S'9S <br />Phone <br />3��' <br />Contr d Price of Work <br />/ZIIJXi � <br />Conlacl Person ( lan Review) <br />1 heie6y certily fha(1 have read and examined fhis application and know the same fo be tme and <br />correcL All provisions ollaws and ordinances goveming this type ol work will be completed <br />�• hether specified herein ornoL The granfing ol a pemut does nof presume to give authonty to <br />-,iolate or cancel the provisions ol any other state orlocal law regulafing construchon or fhe <br />>edormance ol consln�ction. Thaf I am authonzed 6y the owner of th�s property ro peAorm the <br />�vork lor which application is made and I comply with the Stafe Contradors Law 18.27 RCW and <br />?96.200 WAC. _ <br />^� <br />— <br />� . __ ___ -- ��-C�Z-, <br />FEE <br />�IUu ��0�8� <br />