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ELECTRICAL PERMIT APPLICATIOt� <br />CITY OF EVERETT PERMIT SERV[CES <br />3200 CEDAR STREET, EVERETT, �VA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� �� <br />�'r I_� i /�r �.� G�J <br />PROJECTADDi ESS / -�CC f /_��`� <br />C1 7Y <br />.. ��' ��. 1 . <br />Owner <br />Tenant <br />-i <br />� 'Cci ��� <br />Electncal Conlrac�or <br />State License Number <br />Proposed Use of Building <br />Description of Work to De Done: <br />Mail Address <br />Mail Address <br />Mail Address <br />��� <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 />City <br />Clly <br />City <br />State/Zip <br />St2te2ip <br />State2ip <br />Contract Price oi Work <br />Contact Person (Plan Review) <br />l hereby ceAify tha( I have read and examined this application and know, the same to be trua and <br />correct. All p�ovisions o//aws and ordinanr.es govermng th�s type of work will be completed <br />�vhether specified herein or noL The granfing ol a permd does not presume fo give authonty to <br />violafe orcancel the provisions of any other slate or local/aw regulafing construcfion or the <br />peAormance of consfruc6on. That 1 am authonzed by the owner oI this property to peAorm Ihe <br />work (a which applicafion is made and 1 comply wifh the Stafe Contractors La�v 18.27 RCW and <br />296.200 WAC. <br />� I'���, i �/��//7Q �% <br />FEE <br />Phone <br />Phone <br />Phone <br />