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ELECTRIC�4L PERMIT f1FPLICATION <br />CiTY OF EVERETT PERMIT SERVICES �> <br />3200 CEDAR STREET, EVERETT, WA 98201 �_�Q —UZ� <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org �O ���`�6� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT A�DRESS <br />,� <br />Owner <br />Tenant <br />Eleclrical Conlractor <br />7;;. ; <br />S�ale License N�nnber <br />Proposed Use of Duilding <br />Descriplion o! Work to 6e Done: <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 />_ <br />City <br />City <br />Cily <br />State/Zip <br />State/Zip <br />��' <br />S1ate/Zip <br />/," � <br />Contracl Price of Nlork <br />Conlacl Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX COD[ �S 3105 <br />1 hc�eby cerfi/y that 1 have �ead and exa:nined this application and knon� the sarne to be true and <br />correct. All provisions o/fa�vs and ordinances go��ermnr� thrs type of �ro�k wiU L� compfeted <br />whether spec�6ed herein or noL The granting of a pernul does not presume to gi�e aufhority to <br />ciolate or canc2l fhe provisions o/any other state or local law rer�ulaling consfruchon or the <br />pe�fonnance ol%onstruc6on. T; �at 1 am aufhorized by Ihe owner ol this property to pe�form the <br />�.ork lor which application is made and I comply �vifh fhe Stafe Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />� <br />Phone <br />Phone <br />Phone <br />FEE <br />ECJ�C?�' - � l03 <br />