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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />2200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org 1; 1107 _1)70 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />& 10 0 (g <br />Owner Mall Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />P�)gZAVws�uf zql <br />Electrical Contractor Mail Address City State/Zip Phone <br />Q/1a mt22r IB)h Sa� � <br />Stale License Number Contract Price of Work <br />02 1-a A_AO-J <br />Proposed Use of Building / Contact Person (Plan Review) <br />f�/ <br />Description of Work to Be Done: 6rtG * <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 a,:d know the same to be true and <br />1 <br />correct. All provisions of laws and ordinances governing this type u! work will be completed <br />whether specified herein or not. The granting of a pemut does not presume to give authority to <br />violate or cancel the previsions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property toperform the <br />work for which applicatior. is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />/. 4Slgnalure Date <br />