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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 d -7 2 -vie <br />APPLICATIO14S ARE ACCEPTED FROM 8 AM TO 4 PM <br />4a03- RuL- ePE I-Qe <br />PROJECT ADDRESS <br />Owner Mail Address City Statelztp Phone <br />N1� 4Wg <br />Tenant Mail Address City Stale/Zip Phone <br />GL.)7dHS-2, j <br />DT �L �1JG q.26�- S. o Ccas , �tgll� (°6)`blg-14�9 <br />Electrical Contractor Mail Address Ci y /0 Slatethp Phone <br />%; '6Cc�o• o� <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) Description of Work to Be Done: N,mod�F-1 E aj_� <br />A- V e5'�e Vie. C <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 />1 hereby certify that I have read and examined Misapplication and know the same to be true and f�_ 01 17. -CID <br />correct. All provisions or laws and ordinances governing this type of work will be completed <br />whether specified 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 />pedormance of construction. That I am authorized by file owner of this property to perfomr the <br />Ivork for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Signature Date <br />