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Nov, 29, 2012 9 : 09AM No. 6159 P. 3 <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 PROM 8 AM TO 4 PM <br /> Hof C- r"C1 I V .R20 11 <br /> PROJECT ADDRESS <br /> M6� 42,5 9 70 5 <br /> Owner Mall Address city state/zip Phone <br /> Tenant Mall Address City State/Zip Phone <br /> 4eAro Ine !'415 6roadq a Elegy 20 _425259 (P&66 <br /> Electrical Contractor Mall Address City state/ZIP Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Pian Review) <br /> Description of Work to Be Done; i? <br /> �2 - k93 <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 /> I hereby certify that 1 have read and examined this application and know the same to be true and <br /> correct. All provisions of taws and ordinar7ces governing this type of work wll!be completed <br /> tivhe"Or specs ed herein or not. The granting of e perm,t does not presume t0 give authority to <br /> violate or cancel the provisions of any other state or local law regulating construcflon o> the <br /> performance of construction. That l 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 96.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br />