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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 % 1 <br />425-257-8810 - FAX 425-257-8857—www.everettwa.org <br />C-Oi ll -- IS v <br />APPLICATIONS —RE .RE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Owner Mail Address City State0p, Phone <br />/� <br />r ' l / 0 /77- (A:/•'Ctr 7 <br />Tenant Mail Address City Slate/Zip Phone <br />45 fHhS it Se'Ccr /Z4YJ xr, 13/,f L� �n✓4 /it �%%/G)iri rf^J=�!`/' A'tl <br />Ele cal Conlractor Mail Address City State0p, Phone <br />tg&/_E ss y$5- r y 11fl _Yh a 3. - <br />Stale License Number t �� I Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: fi Ott ! / / e lc p (r a,✓e (:ne3 / 11,4 A E c/761rou <br />T %.✓r3 L' ivF � — <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. do <br />�D <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 type of work will be completed <br />whether specified herein or not. The granting of pemat 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 />peAormance of construction. That 1 am authorized by the owner of this property to perform the <br />wodr for which P• olicatfoh is made and I comply with the State ContractorsLaw 18.27 RCW and Lj <br />296.200 WAC. ` j �' I II <br />1, <br />I <br />Signature / 1 'Date <br />