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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 — vvvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />I`io2 SE 1=V �2ETT V�LAI t- uJt 1 <br />PROJECT ADDRESS <br />Neal PD �t �-14t(+ <br />act} 5T T -Zoo �12tolob �44 <br />5-rekbe KT r 0 , 20lI I suJ �1 1SS2-a too <br />Owner Mail Address City State/Zip Phone <br />\1 F_ JgO-L sE. l=vF_fzE_a_ 0AftLW/y 2VCVC,4 wA 97uzk <br />Tenant Mail Address City State/Zip Phone <br />4? S <br />IytF_liel f M ECt+"ICYk_ cVo3o 153Cj Ar-�f QZ� (Alk P13 �E132zy <br />Electrical Contractor Mail Address City State/Zip Phone <br />iz z%wi Z le Z2 Z) A <br />Slate License Number Contract Price of Work <br />Proposed Use of Building ^ Q Contact P{errson, (Plan Review) <br />Description <br />//of,,Work to Be Done: �/L�� �t ✓w� ` ` G 1 �f�1t <br />z''t14"1 vuP0.� <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 that I have read andramined this application and know the same to be true and <br />correct. All provisions of la aws and ordi? nces governing this type of work will be completed <br />whether specified hgoirror not. The g riling of a permit does not presume to give authority to <br />violate or cancellhcsprevisions olany ther state or local law regulating construction or the <br />performance yf construction. That 1 a aulhorized by the owner of this property to perform the <br />work for w iidh application is made rd�comply with the State Contractors Law 18.27 RCW and 0�� i <br />296.20 AC. <br />Si tur Date I ,1 <br />I <br />