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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 PM I —13 0 __0? <br />�� r» 7ti r ilk s G= <br />PROJECT ADDRESS <br />Kry r' \b; `, � ! `.j 79 " si Sjr Z.,IeyAo/7 7 Y. '0 5 <br />Owner Mall Address Gly State/Zip Phone <br />Tenant Mail Address Oly State/Zip Phone <br />Mall Address City - State/Zip Phone <br />�r 5 '7 y _ <br />Slate License Number <br />Proposed Use of Building/ <br />Description of Work to Be Done: <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO <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 application and know the <br />corract. All provisions of laws and ordinances governing this type of work w <br />whether specified herein or not. The granting of a perm7t does not presume <br />violate or cancel the provlslons of any other state or local law regulating con <br />performance of construction. That I am autF 3rized by the owner of this rop <br />work for which application Is made and I comply with the State Contractors L <br />296.200 WAC. <br />Signature Date <br />z0 _5e0 [d <br />Contract Price of Work <br />Contact Person (Plan Review) <br />FEE <br />to be true and <br />and <br />V_MCA-ZOOS <br />