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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETTPERMIT SERVICES q <br />3200 CEDAR STREET, EVERETT, WA 98201 /— <br />425-257-8810 - FAX 425-257-8857 — www.everettwa org 0 9 i.l —b y,5 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�iz,1 I`i;N J h� <br />PROJECT ADDRES�-j <br />Owner Mail Address City State/Zip Phone <br />Tenant Mad Address t State/Zip Phone <br />�L1V� J��I�k <br />[Nln e,4— 01,\ jpg, i(M <br />f'' 9 IC') _ <br />Electrical Contractor Mail dr ss City �S�tate/Zip <br />/�Phone <br />St <br />License Number Co tract Price of Work <br />)m t'. IF Lk, a <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: <br />r <br />'- - <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 />I hereby certify that I have . ead and examined this apalication and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will becompleted <br />whether specified herein or not. The granting of a permit does not Presume to give authority to <br />violate or cancel the pprevisions of any other state or local law regufaating construction or the <br />pedormance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296 J.WAJ. <br />tQ <br />ignatrl . Date `- <br />