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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETi, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />`��Zv 5� f � �V� �U <br />PROJECT ADDRESS <br />�n �'1� /l� �� _�I/lc-v �%�Zv ��� �-Ue 1� <br />Owner <br />Tenant <br />Mail <br />Mail Address <br />� <br />Eleclrical Conlractor ' Mail P.ddress <br />L �5 ��r{- c �� 3�7 P� <br />State License Number <br />��SIr��1 Q' <br />Propased Use oi Buildiny <br />Descriplion of Work lo �e Done: <br />NOTE: 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 />eby certi(y that I have road <br />�cL All provisicns o(laws a <br />her speafied herein or not. <br />fe or cancel fhe provisions <br />�rmance o! constnicfion. Ti <br />lor which application is me <br />200 WAC. / ', , � - <br />� � f'� . ,. / <br />Cuy <br />City <br />`8—a�'1—Og <br />�o �og /65 <br />-�-� iW �i �S2°3 <br />sta�erzip <br />Stale/Zip <br />�O <br />Phone <br />Phone <br />City State2ip Phone <br />� CS—�� <br />Contracl Price o( Work <br />��.1°s�i�� �� ��� s �" <br />^�atact Person (Plan Review) <br />� ���� yi� <br />this npplicafion and know fhe same to be frue ar.d <br />govemuig this type oI work will be complefed <br />�f a pennd doos not prasamo to give authonty fo <br />3fe or local lnw regulafing construchon or fhe <br />ized by fhe owner of fhis proparty to perlomi the <br />Iv �vifh the Sfate Confractors Law 18.27 RCW and <br />� <br />FEE <br />L��/ 1� <br />