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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 r.EDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�/0 <br />PROJECT ADDRESS <br />Owner r\) Mail Address % City State/Zip Phone <br />Tenant Mail Address City ll\� State/Zip Phone <br />lV <br />�',�`\� <br />lectrical Contra or Mall Address City S!ate/Zip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building ( y� Contact Person (Plan Review) <br />Description of Work to BF Done: <br />NOTE WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS. MC OR AC CABLE. G� (( rrU <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have mad and examined this application and know the some to be true and I _ /� <br />v correct. Alf provisions of laws and ordinances governing thus type of work will he completed (> <br />whether specified hemin cr not. The granting of a permit does not resume to give authonty to <br />violate or cancel the provisions of any other state or local law reguPting construction or the <br />perlonmance f constmcGon. That I am authorized by the owner of this roperty to perform the <br />work lorwh'..h application is rmade and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC.-21 <br />\ <br />i <br />Signature D to <br />L00/100'd L05n ££ OL Z H/H/ZO ILOL6999ZV /epojjn0:ww d <br />