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ELECTRICAL PERMIT APPLICA710N <br />CITY OF EVERETT PERMIT S'�RVICES <br />3200 CEDAR STREET, EVERETT, V1' 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />'J4�� ~ ��� l x L�� <br />PROJECT ADDRESS <br />� �/`� ✓� <br />Owner <br />Tenant <br />`i �P !� <br />Mad Adoress <br />Mail Address <br />� ��`�/ V/ ��S � <br />ContraClor M1tail Address <br />State License Number <br />� /� 1 <br />.�/ny�'7_,r�����u� <br />Prop d Use of Building <br />Description of Work to Be Done: <br />u/ <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LGCAL SALES TAX CODE IS 3105 <br />City <br />City <br />City <br />Slate�Zip <br />Slate.�Zip <br />State%Zip <br />Contract Price o� Work <br />Conlact Person (Plan Review) <br />I herebvi ceRily thaf I have read and exammed fhis application and know the same te be Vue and <br />r,;vrr,c[ All provisions o/ laws and orAinances governmg fhis type ol work wdl be completed <br />�vhefher speulietl here�n or not. 1'he g�antmg ol a permd does not presume to give authcnty to <br />>io�ate or cancel tbe provis�ons o/ any other state or local law regu(a6ng consVuction or the <br />penormance ol construchon. That I am aufhonzeAby the owner o( iha property fo peAorm fhe <br />work loi wh�ch appliw6r,n is matle and I comply wdh the Stare Contrar.tors Lew 182? RCW and <br />296.200 WAC. • <br />/ <br />`��/rir�-,/�l/ �� ��,.,�� 1f —���—� � <br />� O'( G � •U 1 9 <br />FEE <br />Phene <br />Phone <br />Phone <br />0 <br />