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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 /> I c zoo to-111- Ali e_ � 9�5 7-0 � <br /> PROJECT ADDRESS <br /> Cin ST CU 16 2A c) pve-"t 2�t,e`tT GJ �� '17-5 3-n ?ti ! <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Xy <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> e) <br /> `I 0 U f '� o0o <br /> tate License Number Con Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> Description of Work to Be Done: 1 N ST 9�1 `,(5c U <br /> -<k-< 41-1 E(^Y- <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 /> l hereby certify that l have read and examined this application and know the same to be true and (� _ (� <br /> correct. All provisions of laws and ordinances governing this type of work will be completed v <br /> whether specified herein or not. The granting of a permit does notresume 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. T at l am authorized by the owner of thisroperty to perform the <br /> work for which application i a e and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> - 0 2 <br /> Signature Date <br />