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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 />, zlld' wJ"114f_ ir�l- 9fiL�1 <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />('kNaoff 9-5z0 G GGG <br />State License Number Contract Price of Work <br />Pr pos d Use of B ildg Contact Person (Plan Review) <br />f <br />Description of Work to Be Done: it,4r, <br />H <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 / r7 <br />1 hereby certify that I have read and examined this application and know the same to be true and Ll I r - U 9 , <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or nor. The granting of n normd does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this roperty to perform the <br />work for which application is made and I ccmply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Signature Date <br />