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t ` <br />a <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 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />3/2� �Rw 11 <br />PROJECT ADDRESS <br />A/l" A 37t-, l6r E � t.J j4 9�zu <br />4�h u G T /tJ�� <br />Owner <br />titan Address City State/Zip Phone <br />Phone <br />Tenant Mail Address city SlaterZip <br />t_KS3ewe&15 W <br />Statc2�p Phone <br />Electrical Contractor Mail Address City/ <br />CY-5-Te 9O0 e� 3P/$co <br />Slate License Number Contract Pnce of Work. <br />Proposed Use of Building //JJ r Contact Person (Plan Review) <br />Description of Work to Be Done: Wr 4'd&.-1 <br />NOTE. WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, 61C OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I2 �L( <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 file <br />performance of consfruction. That I ore authorized by the owner of this pproperty to pedornt the <br />work for -which epplicefiomis made and I comply with the State Contractors Lew 18.27 RCW end <br />296.200 WAG. <br />zr2��v <br />Signature Date <br />`IZ <br />