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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 12)7 //b <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org C 10, 7. �� p <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM l <br />PROJECT ADDRESS <br />e-Y <br />Owner Mall Address Gty Slatemp Phone <br />Tenant Mall Address City State2lp Phone <br />Electrical Contractor RiallAddress City Slatemp ^ — O �r hone <br />State License Number C�ntrecl Price of Work <br />Proposed Use of Building Contact Per, )n (Plan Review) <br />Descd Alon of Work to Be Done: <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 end ordinances got eming this type of work will be completed <br />whether specified herein or not. The granting of a permit does notpprescn,e to give authority to <br />violate or cancel the provlslcns of any other state or local law regurafing construction or the <br />performance of construction. Thaf I am suf cirized by the owner of this roperty to perform the <br />work for which application Is made and I comply with the State Contractors Lew 18.27 RC W and ` 0 <br />296.200 WAC. // 0/c) <br />—y Signal Dale <br />