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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 /> b/O( �O , oi , ?,1d / l 14,/1 /2 <br /> PROJECT ADDRESS <br /> I nk-vi C 4-11121 yz/t) /32 to./ �se)levh_ 1 9 xl— <br /> Owner Mail Address City State/Zip Phone <br /> F14-7-)f ,27»yrs- (0/0/ .%soL, h/ w/ ----1-1, A I.,n/- O, Zos <br /> Tenant Mail Address City State/Zip Phone <br /> 0914 �'jl ,01�Z/P jj. // o V7e i CNf/' w, Fv(�.�f7 9kze <br /> Electrical Co tractor Mail Address City State/Zip Pone <br /> Ual1LuCIti1 Nil- cl, <br /> v, g52..20 <br /> State License Number Contract Price of Work <br /> &Mrh-eAr.i'cJ <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: 007MP r� v�U )) --q")lin 9 -)--C. /�C')1./ k JCf( <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. j <br /> ('1 - 0 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 i 10.._07� <br /> whether specified herein or not. The granting of a permit does not resume 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 forich application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 C. <br /> k.eii/j3l <br /> • nature Dat <br />