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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 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />31 aj 4L-w l Tr 4vd <br />PROJECT ADDRESS <br />,Uj,jr0 �P 7ton/ 392� COL?6y Ate- Cv(5,eojT L.JA RfiAol *4s-.259-bV6T) <br />Owner Mail Address City Stale/Zip Phone <br />I <br />ALL -JCL) '(,orJST2uaT/oN <br />Tenant Mail Address City State/Zip Phone <br />`!�FAmy\ &461_r/j6 Zje 4b03 ,5,tiaf/ Av EEC v-M *A01 415--'&259 <br />Electrical Contractor Mail Address City Slate/Zip Phone <br />11 <br />�R <br />cincT9yy 00 J�SOL) �Sscc��� <br />Slate License Number Contract Price of Work ci �k/ Ilt <br />PflfiC1 <br />"&M tv, i4LL f A <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: t I(Ltr- 5Y51�/✓� i ��eC�Q t 1 � m <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE / <br />BE IN RACEWAYS, NIC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 h/-� <br />1 hereby c-?rfify that ! have read and examined this application and know the same to be true and _ L05V7 <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 resume to give authority to <br />violate or cancel the PPrevisions of any other state or local law regulating construction or the <br />perfomiance of conslmction. That 1 am authorized by fhe owner of this propeAy to perfomt the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />6icjnature Date <br />