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ELECTRICAL PERfV11T APPLICATION <br />CITY OF EVERETT PERMIT 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 AM TO 4 PM <br />� r "7 _� � / J' �—�a.� �J �Sr <br />PROJECT ADDRESS <br />f' �iNll ��rvC�/ <br />Ovmer <br />Tenant <br />^) <br />i 'ZJa�—� <br />Electrical Contractor <br />Slate License Number <br />M11ail Address <br />n7aa qddress <br />Mail Address <br />Proposed Use of Building <br />, , <br />Descnption of Work to Be Done: ___�y'.n J /' ,_% „v:-c-/ <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />Gry <br />City <br />City <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerfi(y that 1 have read and examined this application and know ihe s <br />correct. A/l provisions oflaws and ordinances governmg th�s type oI work �vill <br />�vhether speci(ed herein or noL The grantinc� oI a permd does not presume tc <br />violate or cancel the provisions ot any other state or local law regulating consl <br />peAormance o/ construction. That 1 am authorized by the owner o/ this prope, <br />wc�k lo� which application is ada and I comply with the State Contractors La <br />296.200 WAC. �, <br />J <br />� <br />State�2ip <br />State2ip <br />State/Zip <br />Contrect Price of Work <br />Contact Person (Plan Review) <br />� lo be t�ue and <br />complefed <br />�e authority to <br />!ion or the <br />o peAarm the <br />Q27 RC W and <br />_T_._...�-.-.--..-.-.__,.__.,.,.. .: .. _,,. __ --- <br />FEE <br />Phone <br />Phone <br />Phone <br />