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ELECTRIC/�L !'Ei�MIT APPLICAiIOIV <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-2;57-8810 - FAX 425-257-885? — www.everettwa.org <br />APPLICATIONS ARc ACCEPTED FROM 8 AM TO 4 PM <br />' -�G� <br />cy�7� � �� ,�%1, �,J <br />PROJECT ADDRESS <br />f4a� c< Nr�vr�j <br />�. r <br />Owner <br />ienant <br />Electrical Contractor <br />State License <br />Proposed Use of Building <br />Description of Work to Be Done: <br />Mail Address <br />Mail Address <br />Maii Address <br />NOTE: WIRING !N NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br />City <br />ciry <br />City <br />State/Zip <br />Slate2ip <br />State/Zip <br />Contract Price o( Work <br />Contact Person (Plan Review) <br />1 hereby cedify that 1 have read and examined fhis applicafion and know the same �o be frue and <br />correct. All provisions o//aws and ordinances goveming this type o/ ��ork will be completed <br />whether specified herein or noL The �ranting o( a permit does nof presume tu give authc y to <br />violate or cancel fhe provisions of any other state orlocal law regulating con::truchon or: _ <br />performance o( construchon. That 1 am aufhorized by the owner o/ this property fo pedorm the <br />work lor which application is ,made and I comply with the Slate Contractors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />Phone <br />r2� <br />Phone <br />Phone <br />