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ELECTRICAL PERM!�T APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everellwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />%' <br />�' c � � �,�� � �.t/t.r / <br />PROJECT ADDRESS � <br />5�-:�� �-� �. .� <br />Owner <br />Tenanl <br />< �� <br />�/l'' L- <br />Mail Address <br />1,1ai1 Address <br />Electric2l Conlraclor A1ail Address <br />Stale License Number <br />Proposed Use of Building <br />Description of Work to Be Done: �'}-N't-� � CJL� .� <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Ciry <br />Cily <br />City <br />State/Zip <br />SlalelZip <br />S�atN::p <br />Conlracl ?rice of Work <br />Con!aclPeison (PI-in Review) <br />I hereby certily fhaf I have mad and exnmined fhis application and know the same to be 6ue anA <br />conect AII provisions o/laws and ordinances govemui� fhis type oI work �vill be cornpleted <br />whether speci6ed herein or not. The �ranling o/ a pernuf does not presume to �ive aufhority fo <br />violafe or cancel the �rovisions o(any ofher stafe orlocall�vw regulafing consfrucfion or fhe <br />�eriormance of cons�ructio�i. Thaf 1 am authorized by (he owner ol fhis property to pedorrn Ihe <br />ivork lor which applicati.,n . rnade and I comply ivith Ihe 6tate Contractors La�v 18.27 RCW and <br />296 200 WAC. <br />Si{�naturc <br />FEE <br />Phane <br />Phonc <br />Phone <br />,��� j�� <br />� <br />