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NMI <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857-vvvAv.everethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />4425 !S. Ltd AN-9- /F,/e,,a*r W14 9szol <br />PROJECT ADDRESS <br />Hvol - gLiLri 5 3rd AJP-1 -4uv_1 W1-10192p\ (425�tSrt-S�i15 <br />Owner Mail Address city Stale2lp Phone <br />Tenant Mail Address, city Stateop t Phone <br />Scn�lvr�\t�;� 22z1 (`a1 �nrniat/ g5c7o(_()5 <br />Electrical Contractor Mall Address City StatelZlp Phone <br /><,OW 1TF_*?j1NP `N 410.M.G0 <br />State License Number Contract Price of Work <br />%j00 rjVl2 Ol14eYV Ipa R-Y- <br />Proposed Use of Building �!L Contacl'Person (Plan Review) <br />Description of Work to Be Done: � � 111ACk At _ Qt yl Q x1-.4iy\ck rt o <br />\1� lno04kl SQf 1 A VI :b— <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 certify that I 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 not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am 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 />Signature Da <br />