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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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />PROJECT ADDRESS n /� <br />A`w - ^%wc,ce,k- 7C7:)t 1�. QnSw. 1Cn .X `c�eyne LEA - 1�7�1zi <br />Owner Mail Address City StatetZip Phone <br />Tenant Mail Address city State/Zip Phone <br />Electrical Contractor Mall Address city Slztelzip Phone <br />1124 m-A4 4- l'�2 �-- lk <br />Shale License Number Contract Price of Work <br />Proposed Use of Building rContact Person (Plan Review) <br />Description of Work to Be Done:zg <br />(� r <br />o"rleS <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 true and <br />correct. All provisions of laws and aces governing this type of work will be completed <br />whether specified herein or no ie gra ting of a pemut does not presume to give authority to <br />violate or cancel the PProvisio of any ottt r state or local law regulating construction or the <br />performance of construct' . That 1 am a dhodzed by the owner of this property to perform the <br />work for which applications ade and 1 omply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />% <br />_eIr <br />V Date <br />