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ELP('TRICAL PERMIT APPLICATION <br />.,I fY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org g 6 3_ p 67 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />El'�-ektez <br />PROJECT ADDRESS <br />Owner Mall Address City State2ip Phone <br />_ 5R-7-"E— <br />Tenant Mail Address City State/Zip Phone <br />eo tldo Tri �fLG G <br />Electrical Contractor Mail Address City State/Zip Phone <br />� LD�lSL (ot°2r�_ <br />ate License Number Contract Price of Work <br />Proposed Use of Building -T�^� pp Contact Person (Plan Review) <br />Description of Work to Be Done: y�1G Gh- [o-e-Lee-4-puid •S 1 91A1d:1 %G%w6l— <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 />1 hereby certify tlfat I have read and examined this application and know time 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 a permit does 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 RCW and <br />296.200 WAC. <br />off- LUG 3/WL <br />Signature ate qb 3 _�-7 <br />