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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 1l --o�? <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org C Wo6--069 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />).' n r sxl tiuJ <br />Tenant Mail Address City State/Zip Phone <br />/&Dully <br />Electrical Contractor Mail Address City StalelLp Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />f/ <br />Description of Work to Be Done: <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVEFETT LOCAL SALES TAX CODE IS 3105 IL U(e <br />I hereby certif) Nat I have read and examined this application and know the same to he 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 resume to give authonty to <br />violate or cancel the previsions of any other state or local law regulating construction or the <br />performance or construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 16.27 RCW and <br />296.200 WAC. <br />Signature Date /J _ <br />_�UC vtrr�rLe �i <br />«1 2;z C <br />