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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 3 <br />425-257-8810 - FAX 425-257-8857 - vvvrvv.everettvva.ura G�0 Ya 3 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�`i 1SC �vclhex /-YV � <br />PROJECT ADDRESS <br />Jc;c� cjc ,S> Y Uc-�� U,/\ <br />Owner Mall Address city State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />(uzr '71;Z L/S'61� <br />Electrical Contractor Mail Address City State/Zip Phone <br />6\C,&,-LN ECj&-5 N Z� <br />State License Number Contract Price of Work <br />Proposed Use of Building /� 1,, ,, Contact `Perrson _(Plan Review) ` I <br />Description of Work to Be Done: (90 QW1(� ( \l ry Ark k \17 SU- V � U <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE._ — <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 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 pemut does not presume to give authority to <br />violate or cancel the previsions of any other state or local law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this roperty to perform the <br />work for which application is made and l comply with the State Contractors Law 16.27 RCW and <br />296.200 WAC. [/ <br />Signature Date O� <br />