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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 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ivc <br />PROJECT ADDRESS <br />V(:L,", — <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />1)[xre diner _ <br />Electrical Contractor Mail Address City State/Zip inone <br />State License Number Contract Price of Work <br />Lt V I rat — <br />Proposed Use oT Building Contact Person (Plan Review) <br />Description of Work to Be <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, VIC OR AC CABLE. <br />I <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 presume to give authority to C- o l Q oo 6 <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 ropedy to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RC W and <br />296.200 WAC. <br />Signature Dale <br />