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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.evereltwa org <br />cf ` /7 _o 9 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />rJ/� <br />7010 <br />PROJECT ADDRESS <br />OL<-QQ L13 a L=VL- (ZL I T <br />415 3,2-y.3 <br />Owner Mall Address City State/Zip <br />Phone <br />Ky 2 '7012 EUL�- GQ -L&) WILY LEJERA-lT <br />3515--1� <br />Tenant Mail Address City Stale/Zip <br />Phone <br />l-, 8, Lwc n.0 ,GZo1,2 Q1: LLLVW3- WA <br />ao6-99q-8tj <br />Electrical Contractor Mail Address City Slate/Zip <br />Phone <br />Slate License Number Contract Price of Work <br />D L \ `A 1 L_ �n1i NL <br />t1 <br />K1,j <br />Proposed Use of Building Contact Person (Plan Review) <br />p NSi �L_L_ �% I�O�.JL1'� poLLS <br />Description of Work to BeBo Done: <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAN CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be We and <br />correct. All provisions of laws and ordinances goveming this type of work will be completed <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 />of That by the <br />performance construction. 1 am authorized owner of this roperly to perform the <br />work for which application made and I comply with the State Contractors Law 18.27 RC W and <br />298.200 WAC. <br />Signature Dale <br />1 <br />�, <br />I/ <br />V <br />33 <br />0 <br />O <br />