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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 — W w.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />I L `i rli r Dyt-tea rl IK <br />PROJECT ADDRESS <br />E(uL 7- <br />Owner Mail Address City State/Zip Pnonc <br />Tenant Mail Address City Stale/Zip Phone <br />Ot,�_' �� r <br />Electrical Contractor Mail Address City StalelZip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Reviev) <br />Description of W,)rk to Be Done: r os t C G L V o-, � c1 cg( Add ! 4-i o lrx <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. i <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming this type of work will be completed <br />whether speci(ed herein or not. 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 1 am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />2 <br />Signature Date / <br />