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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 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />PROJECTADDRESS <br />Owner Mail Address City State/Zip Phone <br />P" <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />AL���� g432D� C'�a <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition) <br />Description of Work to Be Done: A-0 p_ <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE.L <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 V <br />1 herehy ceriily th?t 1 have read and examined this application and know the same to he tnme and Q <br />correct. All pro %sions ollaws and ordinances governing thrs type or work will be completed 2O r <br />whether speafied herein or not. The granting o/ a pemut does not resume to give authority to ✓ I 0 <br />violate 0rcancel the provisions of any otherstate ortocal Jaw regulating constrochon or the <br />performance 0l conslrchon. That 1 am authorized by the owner 0f this property to perform the <br />work for <br />which application is made and J comply wdh the State Contractors Law 18.27 RC�V and <br />296.200 h IAC. ( n <br />cJJ <br />ignature Date <br />