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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 8 AM TO 4 PM I O `0 <br />0 71a --7� <br />PROJECT ADDRESS <br />Owner/ Mail Address City StaleZp Phone <br />Tenant Mall Address City StateZp Phone <br />�L � /L � r� � C�% -� � J/ l�lVll� �3�1/� � �- l,�/� • jf5 a U 3 <br />Electrical Co�ngtraactor ,/� Mail Address City State/Zip Phone <br />State License Number Contract Price oork <br />S- F - p. <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: k to r-1 624'' , 12V P <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 j105 <br />I hereby certily that I 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 property tc perform the <br />work for which application is made and/ comply with th,- State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />�a'e�llat /o -3y O <br />Sign ture Date <br />