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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 — vnvw.everett va.org I C' --DL 4 fi <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Owner Mail Address City ha(e/Zip Phone <br />Tenant Mail Address City StalefZip 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 />[� <br />Description of Work to Be Done: L�it� �/i a c S ' _/y l Z�� <br />(� 22 �! <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 previsions of any other state or local law regulating construction or the /I <br />performance of construction. That I am authorized by tire owner of tills roperly to perform the , v <br />work for which application is made and t comply will) tire State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />ature Date I✓ <br />