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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR SFREET, EVERETT, WA 98201 1 <br />425-257-8810 - FAX 425-257-5857 - 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 KIM Address City State/zip Phone <br />Iv,6:- f4y.c 'T f/°o /fir aFdr /ya f ll'� <br />Electrical Contractor Mail Address City State/zip Phone <br />Zoe <br />^/ lo� �zSao -Zaa p <br />j1Js�uioE 7F C <br />Stale License Number l Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: <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 1 have read and examined this application and know the same to be trite 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 permit does not presume 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 lam 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 RCW and <br />296`2000 WAC. <br />Signature Date <br />C0� � <br />