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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 />PROJECT ADDRESS 1 <br />Owner/ C C�l,�l A ddress City State/Zip Phone <br />Q <br />�it^!1<7o�/� ..1, J%a•, �' 126 tam ("u tlr. WA 713 -oo36 <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City State,4ip - Phrnie <br />i <br />&.,•I (vcok) 1LJOC) (44vdeSz+ti 712�rs.Gr" <br />Slate License Number Contract Price of Work <br />fie"-V\4 nl c• 0 � 5 L � + ,c 6 03�20 � i� Ge'Il 26201 `Z& <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: cn, <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 EP <br />1 hereby certify that I 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 />whether specilied herein or not. The granting of a permit does not resume to give authority to <br />violate or cancel the previsions of any other state or local law regu sting construction or the <br />performance of construction. That 1 am authorized by the owner of this roperty to perform the <br />work for which appication de and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />I <br />/L <br />SI net r Dallis <br />