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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.everetNva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />C' Ar. <br />PROJECT ADDRESS <br />/Pori <br />Owner Mail Address city State2lp Phone <br />Tenant Mail Address city State/Zip Phone <br />360 6S-2-33' <br />Electrical Contractor Mail Address city State/Zip Phone <br />State License Number Contract Price of Work <br />/egcM- zrn -/ �� oIr fp.-9k <br />Proposed Use of B Iding (�C or5 OII1 . C7 e L [ Contact Person (Plan Review) <br />Description of Work to Be Done: �L'r1c{ 7 / 1 i 1ip(p✓PrKC'�l l a f^ Q/, �1/t <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 I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local Iaty regulating construction or the <br />performance of construction. That/ 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 />Signature Date <br />