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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 — wvvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />v ROP JECT ADDRESS <br />i) Fly / <br />Owner Mail Address City State/Zip Phone <br />i <br />Tenant Mail Address City Stale/Zip lone <br />I <br />Electrical Contractor Mail Address City StateiZlp Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />/ �Jy <br />Description of Work to Be Conk ///GUi CJI— lelG/ /� Jw/v v / �Cil� ii/' S / LU,;r-a <br />TO <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 /have read and examined this application and know the same to be true and <br />ccrrect. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or nct. The granting of a permit does not resume to give authority to <br />violate or cancel the provisions of 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 made and I comply with the State Contractors law 18.27 RCW and <br />296.200 WAC. <br />Signature Date <br />