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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 /> A�A <br /> ,25 3 <br /> We Awe��e- A�le <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> / X <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address Ci y State/Zip Phone <br /> O`L�ve 15i D <br /> State License Numbe Contract Price of Work <br /> P64,0 Ile <br /> Propos9d Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> � Q f <br /> Description of Work to Be Done: <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. 30 <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 <br /> correct. All provisions of laws and ordinances governing this type of work will be completed L 12- 0 <br /> o/_ <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 l am authorized by the owner of this roperty 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 Dat <br />