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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.everettwel.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> boTM St Si. <br /> PROJECT ADDRESS <br /> ���, Pe QrG�^ �aaa 6or Sfi SE arc ,,ww- '1904 3 Uas 3U� .s <br /> Owner Mall Address City State/Zip Phone <br /> Tenant Mail Address city State/Zip Phone <br /> Electrical Contractor Mail Address city State/Zip Phone <br /> Slate License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: 1 0, 'L 1 P f T v-n .2 Q v-, <br /> ®C� er q v� <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 examined this applicafioo 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 aufhonty 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 the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> A, <br /> ignatwe Date <br />