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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 /> 4m-;o <br /> PROJECT ADDRESS <br /> Lvcc �O '�Oqo ' S <br /> Owner Mail Address City State/Zip Phone <br /> Tenant O Mail Address City State/Zip Phone <br /> 13 - ±aU>SEl <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Pers (Plan Review) <br /> Square Footage (If residential new construction, remodel or addition) <br /> Description of Work to Be Done: r !� <br /> ZC� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. l S4 60 <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 O ' <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 permit does not resume 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/am authorized by the owner of thisroperty to perform the <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br />