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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES SRO S <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org '7v,5'9 -2 —t <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />59 0- F�_lcwhktj 34 <br />PROJECT ADDRESS <br />131,tR r(.t.,k.l�co Sfclwa yZ5- <br />f-twrot" Sic'b-t : ?3a.A 4U4 t-tta,,.L)UUcl Wit q(t3l 3Lfb-282,g <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address city ate/Zip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: Nc -> pc- ,,z t I cj \ <br />OivX. 1 'i Y\ �i 0, <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 I have read and examined th,s 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/ am authorized by the owner of this properly to perform the <br />is <br />work for which application made am: I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />=' Signature Dale <br />