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ELECTRICAL PERMIT APPLICATIO�V <br />.,� � � 0 `1 <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR 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 <br />Mail Address <br />Mail Address <br />r:y <br />City <br /><va 4 <br />Stale2ip <br />Stale2ip <br />6 ��—ra <br />�/04 6 �/a Z <br />Phone <br />Phone <br />�� �. r�y % 3% 2[' i��ul7E�/ I�%' �u rr�% %fJD Y 3 5�-06'lS <br />Eleclrical Conlraclor Mail Address City State2ip Phone <br />1� F ��°� �-� ��I 7 %�tJ <br />Slate License Nurr.ber <br />/0't�n/!/�✓�l <br />Proposed Use of Building <br />Description o( Work to Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br />Con!ract Price of Work <br />Contacl Person (Pian Review) <br />/ hereby certi(y fhat 1 have read and exanuned fhis application and kno�v Ihe same to 6e true and <br />correct. All provi�ions of!a�vs and ordinances goveming this type ol work will be completed <br />whefher specified herein or noL The c�ranting of a pernut does nof presumo to give authonty fo <br />viola(e or cancel fhe provisions of dny other state or local law re�u/ating conshucfion orthe <br />perfomiance o( construcfion. Thaf I am aufhorized by fhe owner ol Ihis properfy to per/orm fhe <br />work for which application is rnade and 1 compty �vith the Slate Contractors Law 18.27 RCW and <br />296.200 WAC. <br />-z�-io <br />FEE <br />