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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 />5 v 6o f veRcT /1101-L 4/4 / l01 <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />1_ac 1' tja5T6,C 1111961 t V iy -' 00 <br />� VriCd Tr r�rl 1� gg2d <br />Tenant Mail Address City Stateop Phone <br />O////'�� yas - <br />14 S i_L667-R'i6 _34dj Nc 6oa&0LL EU6e617- GJ"r fl'DUI .2SZ- l7dU <br />Electrical Contractor Mail Address City State/Zip Phone <br />134141-SU11- 101 Ku P /,SUD F`I <br />State License Number Contract Price of Work <br />R� rfiIL <br />Proposed Use of Building Contact Person (Plan Review) <br />i <br />Description of Work to Be Done: 1 V,51 iXL L jt) y fCK IG NT/A& UAJ <br />A)vcrd Slur 0% J7oiee <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. w <br />7, <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 1=t U�J �(N <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 late regulating construction orthe <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 Low 18.27 RCW and <br />296.200 AC. <br />f � <br />Signature Date <br />