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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.everettwei.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />o 13.Ar11 <br />PROJECT ADDRESS <br />F---1 / r f , l <br />Owner Mail Address City State/Zip Phone <br />Tenant / Mail Address City StatelZip Phone <br />-P,` Sr^ FL� f. 2 3/2 �/ zsiti Q v_ r✓ L� ./ 1,✓c % 403 G 77S —// 9 9 <br />Electrical Contractor Mail Address City State/Zip Phone <br />K£ff TET_ 1�/8 S/° 3oov <br />State License Number Contract Price of Work <br />I <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: A <br />4f <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. 7 y <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify 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 previsions of any other state or local law regulating construction or the <br />performance of construction. TI rat I am authorized by the owner of this property to petlorrn the <br />work for which application is made and 1 comply with file State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Signature Date <br />