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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 P" *951y z <br />e1-105 <br />_7016 -EUVjW IAJ Y <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />HER 13L(�� <br />Tenant Mail Address City StaterLp J- phone <br />}!1�%UE, S 1, A.# � ' <br />i1.2iz'g9k �L L'iRle ZfiJC /�S'O L/� `WL49h'rY1 <br />Electrical Contractor Mall Address City State21p Pn� one <br />OL <br />State License Number Contract Price of Work <br />Proposed Use of Building L, Contact Person (r!an Review) <br />Descriptlon of Work to Be Done: add ,2 a&zlE�S )y Af4pinok <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. S I SO <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hemby certify that I have read and examined this application and know the some to be We and <br />correct All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authorityto <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 Slate Contractors Law 18.27 RCW and <br />296.200 WAC. <br />%adz--- 5=3 <br />signature Data <br />