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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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />782), �e���ly Qf d <br />PROJECT ADDRESS <br />&1,-4 Vbt(d�ei� PD. Bn� 237 �veve� wK 9820� <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of"'orkto Be Done: To II llnc, VfctL ' q k( -ICfGI \ Eyi/•Q�[� <br />NOTE: WIRING IN NON-DVVELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CAPLE. <br />CITY OF EVERE77 L L SALES TAX CODE IS 3105 <br />1 hereby certify that I hb .ad and examined this application and know the same to be true and <br />correct. All provisions or .ews and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting or 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/ 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 1 <br />/ <br />o� <br />Signatu a Dat <br />