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ELECTRICAL PERMIT APPLICATION <br />CITY Or 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 />q 10 ►RESK 1►1 F, _ <br />PROJECT ADDRESS <br />�N \Awi�s O tJ -- — <br />Owner Mall Address City ,aele/Zip Phone <br />Tenant Mall Address City Statemp Phone <br />MMrr CnueijfNc INk. C743 LUSH sr NW 2rinlLJ606 WA Y,z.,91 <br />Electrical Contractor Mail Address City State0p Phone <br /><')MM I 1 000 0(l0 — <br />State License Number Contract Price of Work <br />e�r—r� <br />Proposed Use of Building Contact Person (Plana Review) <br />Description of Work to Be Done: A)LL) igu AMP �A�CI. REMNE KNoa ANtJ <br />Tu9,(--- wm" mew l.i0ii-ju <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 />there certify that I have read and examined this application and know the some to be tnte and <br />correct. All provisions of laws and ordinances governing this type of work will be completeld <br />whether specified herein or not. The granting of a perm Ideas 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 roperty to perform the <br />work for which application Is made and I comply with the State Contractors Law 18.27 RCIV and <br />298.200 WAC I <br />1' lit/ <br />t 111 V <br />S p a ure Date <br />