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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 />TA 5Ur//,. r7dd'/ti <br />Owner Mail Address Cit <br />State/Zip Phone <br />Tenant Mail Address City <br />State/Zip Phone <br />Electrical Contractor Mail Address City <br />State/Zip Phone <br />Slate License Number Contract Price of Work <br />// itrO/'n 1)a-�0A_ <br />Proposed Use of Building Contact <br />erson (Plan Review) <br />Description of Work to Be Done: ,� c .F c f Ok— &eC� <br />!_Q <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO <br />FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALCS TAX CODE IS 3105 <br />1 hereby certify that I have fed and examined this application and know file same to he true and <br />correct. All provisions of 1-,ws and ordinances governing this type of work will be completed <br />whether specified herein or nol. The granting of a permit does riot presume to give authority fo <br />violate or cancel the pprevisions of an), other state or local law regulating construction the <br />or <br />uertonnance of construction. Thaf I am authorized by file owner cf this property to pertonn the <br />work for which application is evade and I comply with fire State Contractors Law 18.27 RCW and <br />zss.zootvnc. <br />Signatut Date <br />