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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 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Ownev Mail Addrem City State0p ?hone <br />Tenant Mail Add ess City Stateop Phone <br />�yLS� <br />(� EAR krc \%&KA \ 3Ya Ptv�W rrnaDoa V 't�$��o 310� 2�o2s.o <br />Electrical Contractor Mail Address City Stateop Prone <br />ALA F c. * VB%AI'a 14L eL4! <br />State Ucense Number Contract Price of Work <br />Proposed Use of Building Contact Person 1(Pla�n Review) <br />Description of Work to Be Done: C1 t I Gt C 2CNA A�( 12 Yer-e p( e-s <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 read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be. completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which applic ' n is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Stg atu Date <br />