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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 />3 -ai-off <br />-- e-DF63-I16 <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />AIiD I,I C ero�d \9 <br />Elecirical Contractor Mail Address city Stale/Zip Phone <br />]a\':P �w\ (�F_- vt As 6 \ r� �- <br />State License Number Contract <br />\Price of Work <br />S\1e.\1l°Q> )i \���ooc,\7Ut%,5C>.— <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: <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 />1 hereby certify that I have read and examfnea' this application and know the same fo be 'rue <br />and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether speci red hereto or not. The granting of a permit does not presume to give author only <br />to <br />violate or cancel the pprovistons of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by flteowner o/this roperty to perfomt the <br />work for which appltcation is made and I comply with the State Contractors Law 16.27 RCW and <br />296.200` WAC. <br />ignature Date � % I <br />