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ELE�TRICAL PERI'►IIIT APPLICAT�UN <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 />� <br />�'r7=J � /�r =%� �<J 7 <br />PROJECT ADDRESS <br />! A. � <<<i� « /�>.-�r� <br />Ovrner <br />Tenant <br />Electrical Contractor <br />State License Number <br />Proposed Use of Buildinc� <br />Descriptian of Work to Be Done: <br />hlail Adtlress <br />Idail Address <br />Mail Atldress <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 />City <br />City <br />StatelZip <br />��S �J �' � <br />S1ate2ip <br />Stale/Zip <br />Contract Price oi Work <br />Contact Person (Plan Review) <br />1 hereby certify that I have read and examined this applicalion and know the same to be frue and <br />correct. Al/ pruvisions of laws and ordinances govermng this type o! work will Ge complotad <br />whether specdied herein or noL The granting o/ a permit does nof presume to give authonty to <br />violafe a cancel the provisions of any other s�ate or local law �egu/ating construcfion or the <br />perfamance o/construc6on. That I am authorized by the owner of this property to perlorm the <br />woik lor which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. y <br />� . <br />FEE <br />I� <br />Phone <br />Phone <br />Phone <br />