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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 /> _ <br /> PROJECT ADDRESS <br /> Owner Mail Address CityState/Zip p Phone <br /> Tenant Mail Address70l Cit State/Zip Phone <br /> "�� ,kJ - 3 - h_ . --(s <br /> Electrical Contractor Mail Address City St. e/Zip Phone <br /> State License Number Contract P'ce of Work <br /> Proposed Use of Building o act Person (Plan Review) <br /> r� <br /> Square Footage(If residential new construction, remodel or addition) <br /> Description of Work to Be Done: / i —n /iEc'CG�J�� <br /> 17e ,,,e 16°C ..7tr <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> q2 . 50 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that/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 <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 consruction. That lam 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 /> E 17)1- 045 <br /> Signature Date <br />