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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 — www.everettwa.org 2✓ —�� 'ib <br />L1063�)t� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />3a/ /2&��y <br />PROJECT ADDRESS <br />;44 <br />Owner Mail Address City Stale/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />n T /=-/ -- r 4- fig- ZI-�) <br />State License Number Contr ct Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Dona I2Y_ 1 — w762 — Pe <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 />1 hereb}1 certify that t have read and examined this application and know the sarne to be true and <br />correct All provisions of laws and ordinances governing this type of Ivork will be completed <br />Miether specified herein or not. The granting of a permit does not presume to give aufhonty to <br />violate or cancel the provisions of any other stato or local law regulating construction or fire <br />performance of construction. 77iat I am authorized by the ottvter of this prcpedy to pedonn the <br />work for which application is mauo and I comply tWh the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Signature Date % <br />