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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 />AVE- <br />PROJECT ADDRESS 11 // <br />kt l� ,grtI �CAr j Ever�{� / f� �82c � 4LS `�4Z vJ <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip I -hone <br />()kjn'� <br />Electrical Contractor Mail Address City Slalclzip Phone <br />State License Number <br />Contract Price of Work <br />Proposed ( fBuild g Contact Person (Plan Review) <br />Description of Work to Be Done: C f' e4 4-e NC,J -rrea � � S f & c � <br />NOTE: WIRING IN NOIV-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily that I have read and examined this application and know the same to be We 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 pernut does not resume 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 1 am authorized by the owner of this property 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 />� /3 v <br />Sig ure IN <br />Date <br />