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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 L- U � 107 <br />PROJECT ADDRESS <br />/< e- /' �. /- Z t K I — <br />Owner Mail Address City State/Zip Prcne <br />Tenant Mail Address _ CitState/Zip Phone �y <br />Electrical Contractor Mail Address City Staloop Phone <br />Stale License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: a e c ff o a o <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 <br />1 hereby certify that 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 permit does not resume to give authority to <br />violate or cancel the previsions of any other state or local law regulating construction or llte <br />performance of construction. That I am authorized by the owner or this property to perfomr the <br />work for which application is made and I comply with the State Contractors Law 16.27 RCW and <br />aS <br />°— Signature Date <br />