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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES /L <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 =AX425-257-8857—www.everettwa.orgr/O�_�3� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />(J�Z' 4 ;�ve'te <br />Owner t Mail Address City State/Zip Phone <br />l� <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />5ay r &(-sto� zu <br />Slate License Number Contract Price of Work <br />Proposed ise of Building I Contact Person (Plan Review) <br />Description of Work to Be Done: ))or't IJ� r 1 `�` /�f Ig- LE _�'-tA71 ON <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 cenily that I have read and examined this application anu know the same to he 'rue <br />and <br />correct. All provisions of laws and ordinances govemmg this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presumo to give authority to <br />violate or cancel the pr0vlslons of any other state or local law regulating construction or the <br />performance of construction. That 1 am authonzed by the owner of this rope w to peAorm the <br />work for which application is mado and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />8 <br />Signature Date <br />