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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 �,�a a.—I( <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org � � � D 9� �� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ISo3 So'� s� �'F <br />PROJECT ADORESS <br />(�I��d l�o�c��,�e��t r1o�.fo"-`rt� Evtic� <br />Owner <br />Tenant <br />In-l7D�tKG7CCxrr L <br />Eiectrical Conlraclor <br />Mail Address <br />Mail Address <br />9'` L I,� <br />Mail Address <br />(N�-foUE.S 95 Za� <br />Slate License Number <br />Proposed Use of Building <br />Description of Work l0 8e Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQl11RED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />Cily <br />Ci�y <br />Cily <br />v�2e <br />/� <br />State/Zip <br />State/Zip <br />SGG� <br />Contract Price of Work <br />Contact Person (Plan Review) <br />FEE <br />1 hereby ceRily that 1 have read and examined fhis application and know the same fo be troe and <br />correcL All provisions ol laws and ordinances govemrng this type o( work wilf be comp/efed <br />whether specified herein or not The �rantinc� o( a permrt does nof presume to give authonty to <br />violate or cancel the provisions of any olher slat2 or local law regulating construcfion or fhe <br />per/onnance oI construction. Tiiaf 1 am authorized by the owner o/ this property to perform the <br />work lor whicli application is made and 1 comply with the State Con6actors Law 18.27 RCW and <br />296.200 WAC. <br />ZZ <br />Phone <br />Phone <br />o6v <br />Phone <br />� <br />v, ��Oq��� <br />V <br />