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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 ""11 <br />PROJECT ADDRESS -� <br />rve(G LI <br />-� <br />Owner PAN Address City State/Zip Phone <br />Tenant / (` / Mail Address /1L /� City p u St/ate2ip /I Q Phone <br />t1 (11y lY ('ll%r 1���_ L��- 1�i. 75�� /lc/O s.�- l,AYl/1L✓A. �i/ — <br />Electrical Contitactor Mail Address City State/Zip Phone <br />Al('�420 <br />State License Number Contract Price of Work <br />Proposed U e of Building r Contact Person (Plan Review) <br />Description of Work to Be Done: �e r ✓i ! �/ / n lA JO L�Ld { [ tG Me be r <br />A 1 i (_ Sb200an,p <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. L Y ) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 t 1 hereby certify that 1 have read anrd examined this application and know the same to be true and C ZG Z — r0 <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether speciried herein or not. The granting of a permit does not presume to give authority to <br />violate or ncel the provisions of any other slate or local law regulating construction or the <br />performs a of construction. That I anm authorized by the owner of this roperty to perform the <br />wo���yy-///or hich application is ma a and 1 comply with the State Confractors Law 18.27 RCW and <br />29820 WAC. <br />Signature Date <br />