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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES yZ <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />'31 i9 Na�eS 5 f" Eva-retr wA <br />PROJECT ADDRESS <br />gall HOOD '515'f [-,Jerett wa Qti?Lo t (�ts)s7e-Kq7 <br />Owner Mail Addrf,cs City State/Zip Phone <br />Advance De5;yn <br />Tenant Mail Address City StateOp Phone <br />30.(oboyleu✓i27+�0^ SF 8��N1 WA �t8o_\2(4Zs)3j1-14 <br />21 <br />—� CI Slate/Zip Phone <br />Electrical Contractor Mall Address city <br />*3PcoC) e29 4 VD $ 95o 0 <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact /Person (Plan Review) <br />Description of work to Be Done: S W X Q o A+ S pD Y ' 1 Z � a ^ � T � •'+� �l rLS 4-o <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 �2 _ <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 constructionThat 1 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 />12— <br />signature liale <br />