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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, E%+ �r_TT, WA 98201 o_bs' <br />425-257-8810 - FAX 42b-257-8b57 - vvvAa.everettwa.org o Sn lY6 <br />APPLICATIOIS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />I _ 472 3 3- <br />Owner Mail Address City Stale/Zlp - Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building II { n �1 a Contact Person (PlanReview) <br />Description of Work to Be Done: k-0. � d %4ia a X lr-Lt& 4-o Ql _ Q_x & i'x� ZCC . e <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVEREIT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 have read and examined this application and know the same to be true and oC5A <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or P.M. The granting of a permit does not resume 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 property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296,200 WAC. <br />1kI3' /�� <br />Signature Dat <br />