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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES -,G -(( <br />3200 CEDAR STREET, EVERETT, WA 98201 i 06 -0 DO <br />425-257-8810 - FAX 425-257-8857 — v/ww.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />ZfB l/F <br />Owner Mail Address City Stat /Zip Prone <br />Tenant Mail Address City Stateop Phone <br />Electrical Contractor Mail Address City Stale/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: R Gs:, / -e, b-�- 9 e t_LE <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />r <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 I I 0 U �ae7 <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />tvhefher specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the pprevisions of any other state or local law regulating construction or the <br />performance of consfmction. That 1 am authorized by the owner of this property to perfomn the <br />work for which application is made and i comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />ignal re � Date <br />