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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 />` a - <br />PROJECT ADDRESS r <br />& 1 �Zr�du 1w Ice. �12&^-1-4 <br />Owner Mail Address City State/Zip Phone <br />53D `!V_e' zt itf'GGeIr_tJ/lGl' GUC't/ef%r/�Z <br />Tenant Mail Address City State/Zip Phone <br />r?�r°�/✓1�1�3-far,t �i�'la—'�tJ?b ��rL�.f�2i' �l�y-P1� /i-(/i-�i.�14� -27odd- <br />Electrical CT ontractL or L' Mail Address City State/Zip Phone <br />State License umberContract Price of Work <br />I <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: (-A <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />'r-✓ G . c517 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be true and 3t7 <br />correct. All provisions of laws and ordinances governing this type of work will be completed (� <br />whether specified herein or not. Tne 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 />perlormance of construction. Titat 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 Lac: 18.27 RCW and <br />296.200 WAC. <br />Signature pate <br />