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I <br />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 vw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � -2 6) <br />-Its <br />f-W)JECT ADDRESS l <br />� j�/�i6 ,�t /� Co r� l c0 �� 7 � � �- ��ih ni o cG' ✓%/ 9�c y�` rJ"' <br />Owner Mail Address City SlatefZip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City Statelzip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: <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 revisions of any other state or local law regulating construction or the <br />perfomrance of construction. That I am authorized by the owner of this roperty to perform the <br />work for which application is made and I comply with the State Corfmcfors Law 18.27 RCW and <br />296.200 WAC. <br />Signature IDate <br />