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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 — vwvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />/gz 7 _ <br />PROJECT ADDRESS <br />f� GcI^!G ytJly �-lSos�!> <br />Owner Mall Address city State/Zip Phone <br />Tenant/ Mall Address City State/Zip Phone <br />1:S cg_" �r �G/r 7�s�s z�r> QUA- ys1�? 3sss�v7 <br />Electrical Contractor Mall Address City State/Zip Phone <br />13 7 <br />�• State License Number Contract Price of Work <br />Prosed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: 7' <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 1 have read and examined this application anr' ,-iw the same to be true and D <br />correct. All provisions of laws and ordinances governing this type Y. ork will be completed <br />whether specified herein o, not. The granting of a permit does n: �f ppco^ume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />perfomlance of constructionThat 1 am authcrized 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. C <br />feef <br />Signature Dale <br />