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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 — wv v"v.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM 6 `t3_oh <br />4gaPntbv Aue_ <br />PROJECT ADDRESS <br />(3n�1,>�_ 1,25., �l�aa C��, do, �,� WA 4�x."?5a.56 <br />Ow{ler Mail Address City Slatemp Phone <br />Tenant Mail Address City State/Zip Phone <br />,0,� — <br />Electrical Contractor Mail Address City Slate/Zip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan [Review) <br />Description of Work to Be Done: 09 ar a <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 />1 he <br />certily that 1 have read and examined ffrls application and know the same to be true and <br />correct. All provlslons ollaws and ordinances governing this type of work will be completed <br />whether 5 ecmed herein ar not. The granting of a pemrd does not presume to give aufhonty fo <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />perfomlan a of cons ruction. That I ern authorized by IIte owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />/Signature I Dal <br />3 <br />