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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.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip _ I'huoc <br /> Tenant Mall Address City State/Zip Phony. <br /> Electrical Coftactor Mall Address City State/Zip <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: y[�/+/ it r�/�4G c /<�y C� /� i�{`�✓ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE I <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that l have read and examined this application and know file 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 pprosume to give authority to <br /> violate or cancel the pprevisions to any other state or local law regulatingothisronstmchon or the <br /> performance o!c structlort. That/am authorized by the owner o!(his roperty to poAomt the <br /> work for whict pp r afion Is m3do and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 W <br /> ionature Date <br />