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ELECT!�ICAL PERMIT APPLICAifON <br />CITY� OF EVERETT PERMIT �ERVICES <br />,;�'10 CEDAR STREET, EVERETT, WA 98201 <br />425-257-b31 �- FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PiN <br />_, % J.� � ��' �r �� .j� t <��l' <br />PROJECT ADDRESS <br />� �l C, � ✓� �: l`I � �- r�o � � � ; � <br />Owner A1ail Address Ciry <br />Tenanl <br />/V o i�T h'w <br />[Ieclrir,al Contraclor <br />State License Number <br />F'roposed Use ol Building <br />Descriplion of Work la Be Done: <br />Mail Address <br />A1ail PAdress <br />n r• <br />U;..� .�^� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />ciy <br />Cily <br />L <br />Sta(e2ip <br />Stale2ip <br />S�atelZ.ip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3'i05 <br />1 hereby certily tl�at I have read and exarnined this applicatior, and kno�v fhe ::ame fo be Vue and <br />correcL All provisions o//aws and o�dinances govcrnmg fhis type o/ work will be complefed <br />whefher spealied herein or noL The gran(in� o/ a perm!, does not presurne to �ive authonty fo <br />violate or cancel the provisions ol any other stafe or local Imv regulatin� construction or tl;e <br />peAormance olconsfruction. Thaf 1 am authorized by the owner o( this properly (o per(orm the <br />work Ior which applicafion is made and 1 comply with the State Confiactors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />C-o�ra-c�as <br />Phone <br />Phone <br />Phone <br />