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r <br />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 />C-►lfv--It <br />APPLICATIONS ARE ACCEPT' r) FROM 8 AM TO 4 PM y <br />PROJECT ADDRESS <br />Orl CJA,,__ il <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address wily State2l? Phone <br />/j <br />Electrical Contractor Mall Address City State/Zip Phone <br />Stale License Number Contracl,Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: Ql <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 1 have read and examined this application and know the same to be true and ._...,. <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of 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 I am authorized by the owner of this roperly to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />/'� <br />296.200 WAC. <br />I0I21I _ <br />Sig nature / Dale - - <br />