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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.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Owner II Mail Address City State/Zip Phone <br />_'7 _ �w' 2=o-3 - 1 <br />Tenant Mail Address City Stale0p Phone <br />) Il 's Vi fin, 2 T Sy, WO.�<4 -464 li to,,vt— -7 01 <br />Electrical Contractor Mail Address City Statelzip 2i 3 ri'honC_ <br />Tc HNSF S 961 6M b 6 <br />State License Number Contract Price of Work <br />Proposed Use of Building I p Contact Person (Plan Review) <br />Description of Work to Be Done:1 x C-.' <br />NOTE: WIRING IN NOIJ-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the settle 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 concel th0w e /movisions of a , other state or local laregulating construction or the <br />perforniance of construction. That 1 am aulhorized by the owner of this property to peAoml the <br />work for which application is mado and I comply with the State Contractors Low 18.27 RCW and <br />296.20 WAC. <br />Signature Dale <br />