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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 — \,Avw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM —� <br />PROJECT ADDRESS <br />Owner Mail Address Gly State/Zip Phone <br />Tenant Mail Address City Slate/Zip Phone <br />t D 14 t/le / y z 3 G -0vTsq woo r� X-C S e"-ty/ ff bZ ti I k► Z s^ <br />Electrical Contractor Mail Address Ciq Slate/Zip Phone <br />L O H 5T xZz7C-j <br />State License Number Contract Price of Work <br />Proposed Jse of Building Contact Person (Plan Review) <br />✓�z �ti ZOO /� <br />Description of Work to Be Done: Sy- r, <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 ^, I <br />1 hereby certify that 1 have read and examined this application and know the same to be true and E f � I aqh <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 <br />performance of construction. That I am authorized by the onmer of this property to perform the <br />work for which apph f ism o and I comply with the State Contractors Law f 8.27 RCW and <br />296.1,60 AC. <br />SI ture Daie <br />