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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 (� a 3 �I O <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� 00 6-,9(20 <br />ono R WR" <br />\ IJ k 9 82 <br />PROJ ECT ADDRE§S <br />Cyb1q. <br />Owner Mail Address City Stale2ip Phone <br />--faQr-�G I u y E N <br />Tenant Mail Address City Stale0p Phone <br />Electrical Contractor Mall Address City State/Zip Phone <br />Slate License Number Contract Price of Work <br />Proposed Use of Building ((���� �� Contact Person (Plan Review) <br />Description of Work to Be Done: Q17 — Wy'� <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 file 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 ropedy to perfomn the <br />work for which application Is made and I comply with the State Contractors Law 18.27 RCW and U <br />296.200 WAC. <br />Signature Date <br />