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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 r^ <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM l <br />/ 6 a2 / 3 ftt% cCJC � <br />PROJECT ADDRESS <br />L�t�o A 1316 <br />Owner Mail Address City StateZp Phone <br />Tenant Mail Address Clly �d State/Zip Phone <br />Electrical Contractor Mail Address Clly StateZp / L��3e3�bfhone <br />C=a2C�L c/ �C 6 SGO 0 ? <br />Stale License Number Contract Price of Work <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 />I hereby certify that I 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 resume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by tile owner of this roperty to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RC W and <br />296.200 WAC. <br />Signature Date + , I 0 <br />