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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.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />C Ize96-oX0 <br />PROJECT ADDRESS <br />i, <br />PY IM!b ZPA IE�7, nb, <br />Owner Mail Address City StatelZip Phone <br />pri Aw- L(w ulllq 2-1 o Ste' Y ax"-6. MAV FPe4tig4'k e---* <br />Tenant Mail Address City StalerZip Phone <br />q7-:5­`774e 9-k35 <br />J-�P,V I A SN .n (-} tAl S '7 4bU -; M-it ., ( 4L A- fKZC3 <br />Electrical bontractor j Mail Address City Stale/Zip Phone <br />Slate Licens Numh ConAC Price of Work W V V' IA1 P l l / ![ 1 va Cal P� Sokf <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: <br />6107.LP�P l t <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. OD <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 l 20 (_ — 0 ZO <br />I hereby certify that I have read and examined this application and know the same to be true and �P <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein ornot. 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 />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 State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Signatr re Date <br />