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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 <br /> PROJECT ADDRESS <br /> r/&- ? 97 �jZ��, <br /> Owner Mail Address City State/Zip Phone <br /> 110 01- <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip ` Phone <br /> /.‘7 i 1 9' c3O, <br /> State License Number Contracctt Price off Work tOw <br /> Proposed Use of Buildin6 Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> Description of Work to Be Done: % �L�'�E' f�_E�'y <br /> • <br /> 4ecY f-e),,,,,Tv <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. Q <br /> 114 <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 true and E103- <br /> o _ 14-'8*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 presume to give authority 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 /> Signature Date <br />