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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 9$201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� � <br />_% / u' ..$ �T� G✓� l.�/ .lo y �'/ <br />PROJECT ADDRESS <br />ir 1�/77r'�-.�'i�I.S! <br />Owner <br />Tenant <br />r'V p ✓� �/1 Y I' <br />Electrical Conlraclor <br />Slale License Nuinber <br />Proposed Use of Buildi�g <br />Mail Address <br />Mail Address <br />� /j .C`//. �il f• <br />Mail Address <br />Description o( Work to Be Done: jti� � i^ r / L�'�' <-i <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEINAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />Cily <br />C <br />State2ip <br />Slale/Zip <br />state/zip <br />Conlrect Price of Wnrk <br />Contact Person (Plan Review) <br />1 hereby certily (ha(1 frave iead and examined this application and kno�v the same to be Gve and <br />correcG All provisions ollaws and ordinances govemmg lAis type ol �vork will be completed <br />whefher specdied herein or noL The granling ol a pernut does nof pr�sume to give authonty (o <br />violate or cancel the orovisions of any other state orlocal law regulafing construclion or the <br />work lor wh �h appl cal or��is n af de and�� co�rr ply K f�}fhe S(ate ContractorspLa v 18.27 RCW'and <br />296.200 WAC. <br />FEE <br />���1� <br />���)1, <br />E� <br />Phone <br />Phone <br />Phone <br />