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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 FM <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />Ln,icJ dT <br />Tenant Mail Address City State/Zip Phone <br />-�rJ /,lfi/CyAi <br />Electrical Contractor Mail Address City State/Zip Phone <br />< L r%( Y,,;3Os — <br />State License NumberT— Contract Price of Work <br />Proposed'Jse 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 />I hereby certify that 1 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. That I am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW art <br />296.200 WAC. <br />&/, r -3 - /U -z5 <br />Signa ure Dale 05 <br />5 <br />