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ELECTRICAL PERMIT APPLICATION <br />PROJECT ADDRESS <br />Owner <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 />Mail Address <br />City <br />q�z7_o <br />G Ilo4-11' <br />State/Zip Phone <br />Rrrcfl'rG /y1A' a%/ 9605 l=vt�vcc � � S�1fCll 1�llzx Lv%9 <br />Tenant Mail Address City StatelZip Phone <br />1alt: <br />Mall Address <br />Tr11c1_N195'7 D3 <br />State License Number <br />Proposed Use of Building <br />51', ., <' W19 9a90 153-Sot6 Y6Yr <br />City State/Zip Phone <br />5,77/ o0 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: LED 4VyTT f n t TAS7 dJO.— <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR,,C CABLE. <br />CITY OF EVERETT LOCAL SALES TF X 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 />whother specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the pprovisions of any other state or local law regulating construction or the <br />performance of construction. That/ am authorized by the owner of this property to perform the <br />work for which application is made and/ comply with the State Contractrs Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />�D <br />l�4 <br />1(04-10 <br />