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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 />YVQll '�" f U/ <br />PROJECT ADDRESS <br />Mail Address <br />City <br />7-aU-iz <br />C-1107-1I(o <br />yf_-?e& <br />StatelZip <br />3�o <br />7?2�? <br />Phone <br />v ✓ <br />Tenant Mail Address City State2ip Phone <br />Electrical ctor Mail Address City Slate/Zip Phone <br />Contra <br />g�S6 <br />Slate License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition) <br />Description of Work to Be Done: 41 <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />(6'As.'I <br />I hereby certify that 1 have read and examined this application and know file same to be true and <br />correct. All provisions of laws and ordinances govemmg this type or work will be completed <br />whether specified heroin or not. The granting of a permit does not resume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or file <br />performance of construction. That I am authorized by the owner of this roperly 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 />- .r- / <br />FEE <br />