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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 />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City Stale/Zip Phone j <br />&324 zcY) � T (art, rr7Z l 6 <br />Elebtrioal Contractor Mail Address City Stale/Zip Phone <br />&I'xPre- 103'?04_ Zm O©O <br />State License Number Contract Price of Work <br />1 F- r\ <br />Proposed Use of Building (t�1 Contact Person (Plan Review) <br />Description of Work to Be Done: n rx L [M o V—e g A-0 <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 heroby certify that I have read and examined this application and know the saute to be true and �� R <br />correct. All provisions of laws and ordinances governing (Iris type of work will be completed <br />whether specified herein or not. The granting of a permit does tie( resume to give authority to <br />violate or cancel (Ire revisions of any other state or local law regulating construction or the <br />perfomrance of construction. That I am authorized by the owner of this roperty to perform 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 />Signature ` Date <br />