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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 /> Aoi <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> lvlq. <br /> Tenant Mail Address City State/Zip Phone <br /> 41114 0 wyl ey- <br /> Electri al Contractor Mail Address City State/Zip Phone <br /> k, it ,_-- <br /> State License Number '�Contract Price of Worrk.�� <br /> Propos6d Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: f4 '11 A) 61_(�JCJ )01' Git/CL <br /> d 0 o6 ILA <br /> S r.L f)02614 <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 /p�(l <br /> 1 hereby certify that t have read and examined this application and know the same to be true and Y V 12-1 V d Z V 3 <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 roperty to perform the <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature I Date <br />