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I ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES y�ao-o6 <br />3200 CEDAR STREET, EVERETT, WA 98201 /, <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org &; 06 0 q ,-/ 4 y <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED I <br />k <br />PROJECT ADDRESS <br />Owner Mail Address City State/7Jp Phone <br />Tenant Mail Address City StateOp Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plana Review) <br />Description of Work to Be Done: (� 104 %�Y <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 certify that I 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 resume to give authority to <br />violate or cancel the provisions of any other state or local law regulating constructicn or the <br />performance of construction. That I am authorized by the owner of this roperty to perform the j <br />work for which application is made and 1 omply with the State Contractors Law 18.27 RCW and �! <br />296.200 WAC. <br />�7 <br />e <br />Signature I Date <br />C-off a►�-i3 � <br />