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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.everettvva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 7 —/ Z .-07 <br />Co70-7-0 7Z <br />PROJECT ADDRESS <br />_ 11,14 _/\ 1 <br />Owner 1 Mail Address City State2ip Phone <br />Tenant ) Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Piicne <br />State License Number Contract Price of Work <br />Cr, - f.l M-t <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done:y� <br />i <br />/ <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 1 have read and examined this application and know file 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 fire provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of thisigroperty to perform the <br />work for application is made a d 1 comply with the State Contrac ors Law 18.27 RCW and <br />296.200 WAC. <br />/ <br />7�z <br />Sig ure- Date <br />} C70) C % <br />