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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 �, //t7s—odx( <br />! — APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Owner Mall Address Cy State/ZipPhone <br />Tenant Mail Address City Stale/Zip Phone <br />,i;�✓�/im <br />Electrical Contractor Mall Address City State/Zlp Phone <br />Slate License Number Contract Price of Work <br />Proposed Use of Building �—D� Conntact Person (Plan Review) <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 />1 hereby certily that 1 have read and examined this application and know the samo to de true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />Whether specilled herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel file provisions of any other state or local law regulating construction or the <br />petfomtance of construction. That 1 am authorized by the owner of this roperfy to perform the / <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and O (7/ <br />296.200 WAC. <br />i%t/rrl� �i/L�— 2 �1Z��/ // <br />r <br />Signature Date <br />