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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 - vvvnv.everettvva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />l91 Z <br />-vwlverei4v� <br />PROJECT ADDRESS <br />&Its 1810 L velt'4i-4x t <br />Owner Mail Address Cly Statamp Phone <br />(�-:I, <br />Tenant Mail Address C city StaleMp Phone <br />i <br />N I I -r I i� sok t-QcL, I+ 5qU I l-IN> III;?- SrC 44 1't I%vT1 I1ri.0b xk'� 1 <br />Electrical Contractor Mail Address Nl3city-y\\ staloop Phone <br />�oJLIS. 0.(r' <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: AAA CUlg iiA A a mrnktnD i C 11 Ski/ <br />I f <br />Lj <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 fa 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 16.27 RCW and <br />296.200 WAC. <br />` Z'f& 7/ 0i <br />Signature ID to <br />It <br />