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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, W4 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS'/ <br />,�--��/_-'/_4N H G"Si�c.Q /E��t 7 ��iw�v�b�✓ �C. % /fir u�-vyi9$� G✓�4 �} FF.s�?I.� <br />Ownci Mail Address City Sun /Zip <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />l ano <br />State License Number Contract Price of Work <br />AI t//4- -P_ ciS -t <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: le- <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 hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions oflaws and ordinances governing this type of work will be completed/ <br />whether specified herein or not. The granting o/ a permit does not prosume to give authority to <br />violate or cancel the pprorovisions of any other state or local law regulating construction or the <br />performance o/canstrurrion. That 1 am authorized by dte owner o/fhfs property to perform the <br />work for which application is made and I comply with the State Contractors Lew 18. 27 RCW and <br />296.200 WAC. <br />Signature Date <br />