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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 />Owner rMall Address Clty State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />��c��%��cT< </�z/ �z`� �i{�r�C�u,�,��/� car¢ �8z�z <br />hon <br />Eleclri al Contractor Mall Address city State/Zip 7Z� _� jv_e� <br />State Ucense Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done:�Z <br />NO i E: 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 />I hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provlNons of laws and ordinances, governing this type of work will be completed <br />whether specilled 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 consruction. That I am authorized by the owner of this ropedy to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and ' Cal <br />296.200 WAC. V <br />f <br />Slgnatu Date <br />