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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 <br />ham/ 9ff208 <br />PROJECT ADDRESS <br />Owner Mail Address City Stale/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />I <br />Electrical Contractor Mail Address City State/Zip Phone <br />efgy <br />Slate License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: Lo;�,�!/ ✓�.Ycai �t /�caiy�2 C��c�r{� �Dv^ <br />A:GW->r "e, Z74-,r 'yt/I�tilt/f <br />d <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. y� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily that 1 have read and examined this application and know fire 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 resume to give authority to <br />violate or cancel the revisions 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 to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Signature Date <br />Co)cDo1-ram / <br />40 <br />