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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE i, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT$ CREDIT CARDS ARE NOT ACCEPTED <br /> �IIZ FLorzibA 1�y <br /> PRO.lECT ADDRESS <br /> �6NNA .LrJ G2�,�7 <br /> Owner Mail Address City State2lp Phone <br /> Tenant Mail Address Ciry SlataZp Phone <br /> YtA23o�R- �o�n�T FLeGTR 1 L L�1L �0�1�� /lv6�ST SW �`-''N,vG�oeO WA `�37 yls7{[- zfL <br /> ElecVical Contractor Mail Address City State/Zip Phone <br /> �rrrcaovF 9G9 �7P �ao�. av <br /> State License Number Contrad Price of Work <br /> s.�, (� STA.v G p�e i..1 !t E IZ <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: l 2 S y.�m( �A�✓L � CN,�ni G a_ <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 this applicatlon and know the same to be bue and <br /> correct. All provisions ollaws and ordinances goveming this rype of work will be completed <br /> whether specified herein or not. The granting of a permit does nof presume to give authority to <br /> violate or cancel the provisions ol any other state or local law reguleting constructfon or the <br /> performance of construction. That I am au[honzed by the owner o/this property to perform the <br /> work for which appli�afion is made and I comply with the State Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> _��� �����r�i, 3-� - � s— <br /> Signature Date <br /> �0503-o l I <br />