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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 />PROJECT ADDRESS <br />AAr2'J ft.i��, INI 16731 PAiLallc�,ta�ti ccl 9&vl <br />Owner Mail Address City Slate/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Phune <br />Stale License Number Contract Price of Work <br />Proposed Use of Buildinq Contact Person (Plan Review) <br />���q���' r <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 hereby certify that I have read and examined this application and know the sarno to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether All <br />herein or not. The granting of a perm does not Aresume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />petformance of construction. That I am authorized by tire 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 />296.200 WAC. <br />r— DI , <br />Signal, re Date <br />