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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 />t <br />PROJECT ADDRESS <br />Owner Mail Address City btatelzip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor mail Address City Stale/Zip Phone <br />L!ot Pezf(6111F (0<s <br />State License Number T Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Lone: 7VAs iC( thulP ✓ cj �AI -�LT Iy - (Q i L'\/j <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 3105 <br />I hareby certify that I have read and examined this application and know the same to be true and ! ,^ <br />corrocf. AH provisions of I ws and ordinances governing this type of work will be completed <br />whether specified her not. Th ranting o; a permit does not pprosurne to give authority to <br />violate or cance/ the ppro sions y other state or local law rogn/afinq construction or the <br />performance of consfr cfion. I I am atr!6onzed by the owner of this property to perform the <br />work for which appli tion ' made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. ' <br />A Cr <br />��' Signature Dal <br />