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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 - wwv✓.everettvva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Lf4'O( Sau/1. 3i�, �✓o.,ce�i�,/6'� cL�'Zc�3 <br />PROJECT ADDRESS <br />/ 16?r7l7 Soc,NdUrtiLJ�L, ic�z f <br />k 2i. 4rCt/L C.O✓xr"'Vos, /N/4 (7862-0 G)Z 36HL <br />Owner Mail Address City StateZp Phone <br />Tenant Mail Address City State/Zip Pnonc <br />Electrical Contractor Mail Address City State0p {'none <br />Stale License Number Contract Price of Work <br />)-etf SOialAC 4f USG SGar.� <br />Proposed Use of Building 7 Contact Person (Plan Review) <br />Description of Work to Be Done: Au,-( ji- ec 7.c /c,4 4C /It Oa rG 14//4L C S 41 <br />/ ^ r <br />)`ouc 5 d- fof. I cf/ „�evF c Y <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 />I hereby certiry that I have read and examined Phis application end know the same fo be true and <br />con ec All povisions o/lews and ordinances govemmg dris type olwork will be completed <br />wllother specified ltererrt or not. 'fie granting of a permit does not ppeesume fo grve authority to <br />violate or cancel the pprroovisions o/ any other state or local law regulating construction or the <br />perlormanee o! construction. JhaI I am authorized by the owner of this pmpedy to peAorm the <br />work !or whidr application is made and I comply with the State Contractors Law fa.27 RCW and <br />296.200 WAC. <br />L( f�., / __ '�'-1S- oET <br />Signature Date <br />Fco3 c�i8 <br />