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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98?C1 <br />425-257-8810 - FAX 425-257-8857 — www.eve rettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />dKuct��z �ti >� c� k� <br />PROJECT ADDRESS <br />Owner Mail Address City Slate2ip Phone <br />�.t vCK 437,7 6zuc(�,� ;=l,1, icy (u C7�I,to �fECA <br />Tenant Mall Address City State/Zip Phone <br />Lc-emic JPUo ,K2n IALD'c LOCc9VLA+'cA,,lulu.Ctf� a2�zf�3j <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number Contract Price of Work <br />'TAX -(?rZ� ' <br />Proposed Use of Building Contact Perscnn (Plan Review) <br />Description of Work to Be Done: �� L L t2(� at � ICrf.1 /� <br />,'�'�5 <br />�. fc-u� SiC1r-1 <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES 1AX CODE IS 3105 <br />1 hereby certify that I have read and examined this applicati^n and know the same to be true and <br />correct. All provi bns of law nd ordinances governing th,; type of work will be completed <br />whether speci( herein or of The nV of ermit does not presume to give authority to <br />violate or cant I the pprov' ion of a they sta r local law regulating construction or the <br />porfotmat I constru ton The ah ho d by the owner of this roperty to perform the <br />work for ' h app(ica on ' me o with the State Contractors law 18.27 RCIN and <br />296.2 C. <br />Signaler- Dale <br />