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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 JJ <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />ur�� v I Q, <br />Owner Mail Address city Staleop Phone <br />Tenant Mail Address City State/Zip Phone <br />U0Vl��` <br />Electrical 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 />Description of Work to Be Done: W' 1 t Q ✓i ; ` .GA1 cz; ` C, <br />1 <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 I have road and examined this application and know the same to be true and <br />correct. All provisions oflaws and ordinances governing this type of work will be completed d <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the previsions of any otter state or local law regulating construction or the <br />performance of construction. That lam authorized by the owner of this property to perfomr the <br />work for which application Is made and I comply with file State Contractors Law 18.27 RC W and <br />296.200 WAC. <br />y' Lv`fy"`�` <br />Signature Dale <br />