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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 — �,nww.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />PROJECT ADDRESS / <br />� L t c l it""/� Ky'/ <br />l 7 7 ✓ Gtlpl ��o�t7 <br />Owner ��� Mail Address City StaletZlp Phone <br />Tenant Mail Address City State2lp Phone <br />Electrical Contractor Mail Address City Slale.rZip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building ContactPerson(Plan Review) <br />Description of Work to Be Done: / `�Y� ✓/ / � �� ` � /'�/" e <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TA:( CODE IS 3105 <br />1 hereby certify that 1 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 permit does not presume 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 roperly to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />298 200 WAC. <br />I Signature Date <br />