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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.everellwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROJECT ADDRESS <br /> 2- <br /> Owner <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mall Address Cil) Slate/Zip Phoi.e <br /> =Ge<.Tr- /tip & r- C/ 98zl3 gg3e <br /> Electrical Contractor Mall Address City Stale/Zip Phone <br /> EleA" 16IZ� > « <br /> State License Number Contract Price of Work <br /> 06-5 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: /N S 7'A 4- C G-C Al • TRP U ` le6 jr <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 tme 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 pemuf does not presume to give authority to <br /> violate or cancel theprovisions of any other state or local law regulating construction or the <br /> performance of construction. Thai I am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with file State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> signaturej Date <br /> Ir <br />