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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 />� ��-� 1 I Z`'y- �S� S�� �� `/ <br />PROJECT ADDRESS <br />��I� <br />Own'� <br />�i <br />Tenant <br />Mail Address <br />-I�(��� <br />Mail Address <br />��2- v �SL � <br />State License N mber <br />(� (�,�n i-�ti �.< <� <br />Proposed Use of Building <br />Description of Work to Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� <br />' (.��v Z.�-�' �/ c� � �� <br />State/Zip <br />l/ <br />// <br />Phone <br />State/Zip Phone <br />�/ZS� �1��:� j T- <br />State/Zip <br />-� ��,G-- <br />Contract Price of Work <br />�. ����' Jl ►�' C� l,» <br />Contact Person (Plan Review) <br />FEE <br />�� � �� <br />Phone <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 govemmg this type of work will be completed �����"" i�� � <br />whether speafied herein or not. The granting of a permit does not presume to give author�ty to <br />violate or cancel the provisions of any other state or local law regulating construcfion or the <br />performance 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 />296.200 WAC. <br />Signature Date <br />