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ELECTRiCAL PERMIT APPLICATlON <br />ClTY OF EVERETT PERMITi 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 Ah1 TO 4 PM <br />; /-� j j'j .l�%7 l.✓ <br />PROJECT ADDRESS <br />Owner <br />/�7�1 ,-. <br />Tenant <br />Mail Address <br />�/�/YY /'l"J.SY <br />tvtail Address <br />� � ��� Lr% <br />Electrical Conlractor �� Mail Address <br />Slate License Number <br />Proposed Use o( Building <br />Description o( Work lo Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Ciry <br />City <br />Cily <br />State/Zip <br />SlaielZip <br />Slale2ip <br />Conlract Price of Work <br />Contacl Person (Plan Review) <br />I herehy cerlily thal I have read and examined this applicafion and know the same to be true ana <br />conecL All provisions al la�vs and ordinances goveming this type of work will be complvted <br />wheflier specdied herein ar noL The 9ranfin� oI a pernut does not presume to give au(honty to <br />viol�te or cancel the �rovisions o( any other stafe orlocal law regulatin� constructior or fhe <br />peAonnance ol construction, That i arn aufhorized by Ihe owner o/ this property to peAomi the <br />�vork !or which application is made and 1 comply u�ifh the Stafe Contractors Law 182, RCW and <br />296.200 WAC. <br />FE[ <br />c= a�b�—��l�- <br />Phone <br />Phone <br />Phone <br />