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ELECTRICAL PERMIT APPLICATION <br />CITY OF E"ERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org G- <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 1 <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Ph ne <br />'3(,o Sb / 7�-�� <br />Tenant Mali Address City Stale/Zip Phone <br />Electrical Contractor Mail Address City State/Zip y. Phone <br />f 'la r% �Z'o 3c/ido. oa <br />Slate License Number Contract Price of Work <br />Proposed Use of Building //-� Contact Person (Plan Review) <br />Description of Work to Be Done: YJ 0�G <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE 1 <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ri I ��,� C <br />1 hereby certily filet I have IL <br />read and examined this application and know fho same to be true and L <br />correct. All provlslons o/laws and ordinances gova Ing this type of work will bo completed <br />W ellter spacihed herein or not. The granting of a pennrf does not presume to glue aufhonfy to <br />violate or cancel file provistons of any ofhersfafe orlocal law regulating construction or the <br />perfomlance of constmction. Thot I am authorized by III owner of lhls roperfy to pedomt the <br />work for which appllcafton !s made and 1 comply with the State Contrectors Lew 18.2' RCW and <br />296.200 WAC. <br />Signature Date <br />00 - D ° <br />