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r <br />ELECTRICAL PERMIT°*APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 93201 i <br />425-257-8810 - FAX425-257-8857—www.everettwa.org Il'L <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Owner 7 Mail Address City State/Zip Phone <br />70/0 <br />Tenant Mail Address City State/Zip Phone <br />C�3 ly lrti%rz.� Igo 1 n�1 7- �1 I,�II��u-� �.v✓-i- �c-�'7 <br />Elect&al 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 />r / <br />Description 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 />/ hereby certify that I have read and examined this application and know the same to be true and C & I vlD 9 <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or riot. The granting of a permit does not presume to give authority to <br />violate or cancol fire pprovisions of any other state or local law regulating construction or the <br />performance of construction. Tlmat I am authorized by the otvner of itils roperty 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 />ZZ- Zb/o <br />ignature / Date <br />