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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - Fi%,X 425-257-8857 — www.everettwa.org <br />C-►ZoI --lpq <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SSlnj F're I 1A _A UJC(U <br />PROJECT ADDRESS <br />S�e�p C_OLAv14V4 (n-70�"`SF d Wp Q�032 <br />Owner Mall Address City StaterZip Phone <br />%lek V C S S t S(_ 0 u l-- F-c V S <br />Tenant Mall Address City Stateop Phone <br />C,l.wrZ-(T'-( SIbr4c-' <br />Electrical Contractor Mail Address City StateOp Phone <br />LLtin tzk S t q - L - 1 ztD <br />State License Number Contract Price of Work <br />Proposed Use of Building { Contact Person (Plan Review) <br />Description of Work to Be Done: <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 />I hereby certify that 1 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 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 1 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 />gnature Date <br />