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l <br />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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />PROJECT ADDRESS <br />?a'5 'w"35 -?415 s�- YJ �ioo�c�tiC h1 � ` 7;8--95!/ <br />Owner Mail Address 'city State/Zip Phone <br />-X?&/ ,,Fe — far �'3a3 <br />T;nn�a�nn1 r� Mail Address city State/Tip <br />4t�/ Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />45 <br />State License Number Contract Price of Work <br />Proposed of BuildingU Contact Person (Platt Review) <br />Description of Work to Be Done: i <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 O J <br />1 hereby certify that I have read and examined this application and know the same 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 permd does not presume to give authority to <br />violate or cancel the provisions of any other slate or local law rogu sting construction cr the <br />performance of construction. That I am authorized by the ormer of this property to perform the <br />work for which application is made and I comply wdh the State Contractors Law 18.27 RCW and <br />296,200 WAC. <br />E / e _ <br />Signlylbre Date' <br />Fo4od-oa3 <br />