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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -wwrN.evereltvva.org <br /> APPLICATIONS ARE ArCEPTED FROM 8 AM TO 4 PM <br /> � 0S 6ls-r 5f S � <br /> PROJECT ADDRESS <br /> Owner Mall Address City Stateop Phone <br /> Tenant Mall Address City State/Zip Phone <br /> O LA)vJ2� _ <br /> Electrical Contractor Mad Address City State/Zip Phone <br /> Stale License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Donn: 0 dr / I,d ISI - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 !� <br /> iromicty certifylvisions ollews end oNlnences thisapplication <br /> (his type o/work will be co plefed and <br /> whether specified herein or not. The granting of a perm t does not presume to give authority to <br /> violate or cancel the provisions of any other state or local low regulating construction or the <br /> performance of construction. Theft am authorized by fire owner of this roperly to perform the <br /> work for which application Is made and I comply with the State Contractors Lew 18.27 RCW and <br /> 286.200 WAC. <br /> 5f <br /> SIbbiliture V Date <br />