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ELECTRICAL PER11�1i7 APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3'<'.00 i;E4AR 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 />�j� S/ S-� S`r.�.� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Electrical Conlraclor <br />Slate License Number <br />Proposed Use of Buildinc <br />Description of Work to Be Done: <br />�� � �..�— <br />Mail Address <br />Mail Address <br />Mail Address <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SO,LES TAX CODE IS 3105 <br />City <br />City <br />City <br />State/Zip <br />State2ip <br />Stale/Zip <br />Con!ract Price af Work <br />Contact Person (Plan Review) <br />r ����< <�ti zL ,Co �, �- � <br />I hereby certily fhat I have read and examined this applicafion and know the same to be true and <br />correct. All provisions o( laws and ordinances govemir;g this fype o/ work will be completed <br />whether specified herein or noL The granting of a permd does not resume fo give authonty to <br />violate or cancel the provision:; o/any ofher stale or local!aw reguPting construction or fhe <br />peAonnance of construction. Thaf 1 am authorized 6y fhe owner of this property to peAorm the <br />svork for which application is made and 1 compty with the Sfate Contractors Law 18.27 RCW and <br />29G.200 V✓AC. <br />Phone <br />Phone <br />Phone <br />FEE <br />� <br />� oso�k-a�u� <br />