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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.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />t 56 <br />PROJECT ADDRESS <br />�] <br />&LIE <br />Owner i Mail Address �City State/Zip � one <br />Tenant Mall Address City State/Zip Phone <br />lectrical Contractor Mail Address CI State2lp Phone <br />g6spz- 4mv -Qa <br />State License' Number Co ffracl Price of Work <br />Proposed Ube of Building //! z��✓ /nContact Person(PlanReview) A <br />Descriptlon of Work to Be Done: �00 Alylp �QM FI � l K I,fY' L /z/C M-'f' uj'y _ <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED 1 J FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />r <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 same to be true and f 0cp la <br />correct. All provisions of laws and ordinances governing this type of wurk will be completed <br />whether specified herein or not. The granting of a pemuf does not resume to give euthodty to <br />violate or cancel the pprovisions of any other state or local law regulating construction or the <br />performance of constmm cfion. That I am authorized by the �• er of this roperty to perform the <br />work for which application is made and 1 comply with the State Confractors Lew 18.27 RCW and <br />296.200 WAC. <br />Signature Date <br />