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;' <br />ELECTRICAL PERMIT APPLICATION <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 />./ `/� C� <br />PROJECT ADDRESS <br />f_lJcn/�/ �� <br />owner i <br />Tenant <br />c`j�/AJis /�=� <br />Eleclrical Conlrector <br />Mail <br />Mail Address <br />Mail Address <br />State Licenso Number <br />�, / � ,;�; <br />/� r,�i-l7� <br />Proposed Use o( Building <br />Description of Work lo Bo Done: _ <br />� � �� ��� yr- <br />City <br />City <br />City <br />�'��F'L— <br />NOTE: WIRING IN NON-DWELLINGS IS RGQUIRED TG <br />BE IN RACEWAYS, MC ORAC CABLE. <br />CITY OF EVERETT LOCAL Sf.�ES TAX CODE IS 3105 <br />1 hereby certi(y that ! have reod and exantined this applicalion and know <br />cerrecL All provis7ons o//aws �nd ordinances �overnmg this type cl wo <br />�vliether specilied herein or not. The �ranfing o/a pennd does not pros <br />violafe or cancel fhe �rovisions o/any olher sf�te erlocal law regu/aGng <br />performance o(conslruction. That 1 am authorized b}� the o�vnerol this <br />u�ork lor �vhich application is m�3do and 1 cornpty :rifh the Slate Confrac <br />29Q200 WAC. <br />� � . <br />� <br />.i �:,�> C ,i�_-,-.i <br />Signature ' � � Date <br />�-' <br />SlatelZip <br />State2ip <br />State/Zip <br />Conlracl Price of Work <br />Contact Person (Plan Review) <br />Phono <br />Phone <br />F[E <br />fhe sarne to be true and �� U�� , i G� � <br />rk �vill be complefed 1 / <br />ume to give aufhonty to <br />construclion or fho <br />property to peAomi the <br />(ors Law 18.27 RCW and <br />'I- <br />