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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 t <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />PROJECT ADDRESS <br />a/7 if C�. 1 I !mil 74'r'I'/C �3 e <br />Owner Mail Ad6ress City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor `' Mail Address city State/Zip Phone <br />State License Number Contract Price of Work <br />i <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: 72 / .1' ✓ 21 , c, <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 and know the same to he true and 1 <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 permit does net presume to give authonty to <br />violate or cancel the provisions 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 to perform the <br />work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Signature ` / e <br />