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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 /> 2_6 o1 EVEQ,c-r- a $Zd <br /> PROJECT ADDRESS <br /> ART SKOTDAL Z.1 07 ( oL6 , Sua- - IZ0® Z5-Z5Z-5go0 <br /> Owner Mail Address City State/Zip Phone <br /> EOC TT w q�Za� <br /> nt Mail Address City State/Zip Phone <br /> C±C 2o6,n + ?oPLAR-WM YNn) <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> GG CL_6 c qZ9 kq Al It- <br /> State License Number Contract Price of Work <br /> l O Z L & T ATS / M%XE \-4. <br /> Proposed Use of Building Contact Person (Plan Review) <br /> • <br /> Description of Work to Be Done: '7 d O A ` I 'TV-1-kvO 2 AS' POL3( -R <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. 0 O 6 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 herebycertify that I have read and examined this application and know the same to be true and h Q <br /> correctAll provisions of laws and ordinances governing this type of work wi .sV <br /> ll be completed I I <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 construction. That I 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 /> 1 - 7_0 l L i <br /> Signature Date <br />