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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 a —D 1 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org C 0-7 a �� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />4) 31 Zo C <br />PROJECT ADDRESS <br />Owner 7 Mail Address City State/Zip Phone <br />Tenant Makkddmss City SlatelZip Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />Stale License Number Contract Pi ice of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: � �� C.-(' 4.) <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 be true and 1FOl p 1 -112) <br />correct. All provisions of laws and ordinances governing this type or work will be completed <br />whelherspecdied herein or not. The granting of a pemid does not presume to give authority to <br />violate or the pprovisions of any other state or local law regulating construction or the <br />p ornian of c slmction. That I am authorized by the owner of this property to perform the <br />wo1k for w A h app ation is made and I con+ply with the State Contractors Law 18.27 RCW and <br />2 21 V i <br />Slgna re Date <br />0 <br />