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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 �/ g <br />425-257-8810 - FAX 425-257-8857 — wnvw.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 Mail Address City Stale/Zip Phone <br />Aj�, ,ea,, >lIw 4tie <br />Electrical Contractor Mall Address City Slalel//Zlp Phone <br />e <br />r00 <br />State License Number 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 />I heroby certify that 1 have read and exorn!nod this application and know the some to be true and <br />correct All provislons of laws end ordinances govomrng dos type of work will be cornplefed <br />whether specified herein or not. Tho granting of a permit does not presumo to give authority to <br />violate or cancel the provisions o/ 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 rnado and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Si'gnulure Otte 'y_ 09 11 —C) 5 <br />