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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 425-257-9857 —www.everettwa.urg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROJECT ADDRESS / <br /> Owner Mall Address City SlaterZip Phone <br /> Tenant Mail Address / City /� StateiZZiip� Phone <br /> �_ <br /> ;2.)-1;2.)-1 /%[., L%�t C.rl L ( l r 'A c�Vt; ill D . &5_ /0 z 7/�/�a��>'1 u ctL � <br /> Mg !r o <br /> Electrical Cunlraclor Mail Address City Stale2lp Phone <br /> � Yes-y2r r,3B <br /> State License Number Contra t Price of Work <br /> Proposed Use of Building Contact Person (Plana Review) <br /> Description of Work to Be Donn: o,.,{,2-i"'-f khl- �4,- s - <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 1 have road and examined this application and know the same to be true Ono <br /> correct. All provisions of laws and ordinances govommg this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not rresume to give authority to <br /> violate or cancel file ropKKfisions of any other state or local law regullating construction or the <br /> iveo for which appl cons <br /> i la r aido and I complye with the State Contractors Law 18 27 RCW end <br /> 296.200 KIAC. <br /> It <br /> rgnalure Date <br /> X03 _ //� <br />