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Mar 12 15 06:16a Bob Jack 15096746777 P.1 <br /> • 0 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98209 <br /> 425-257-6890 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROJECT ADDRESS <br /> Owner Mail Address <br /> City Slate/Zip Phone <br /> Tenant Mail Address city State/Zip j� Phone <br /> f <br /> Electrical Contractor Mail Address City State2i _ Phone <br /> State License Number Contract Price of Work <br /> ?C) 1 5-/,t a� -C 1__� C 1< <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: j'LAz.S f4G xv e4'L) �L , <br /> ' AD/ <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 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 <br /> g g type of work will be completed <br /> whether specified herein o. granting of a permit does not resume to give authority to ! 6 <br /> violate or cancel the p isions of a y other state or local law regulating construction or the <br /> pertormance of const ction_ That dam authorized by the owner of this property to perform the <br /> work for which appli tion is made., d I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signet e ` pate <br />