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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 />l 7'5 S <br />PROJECT ADDRESS <br />�I OJc] �¢c�✓r <br />Owner Mall Address City State/Zfp Phone <br />Tenant Mail Address City State/Zip Phone <br />C�ilti'/¢ C )2C�/2i C —f7e 'e5goV— 2267yfr St✓ 4*17 l.AJe, 9�a�3 Zeb �i17Svs <br />c <br />Electrical FD Tractor Mail Address City State/Zip Phone <br />pU <br />1/�I)sy.14 <br />State License Number Contract 1Price of Work <br />Proposed Use of Building Contact Person (Plan Review) n <br />Description of Work to Be Done: 57D) <br />I <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 />1 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 />whether 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 )r the <br />performance of construction. That i am authorized by the owner of this property to pertorm the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Signature Date E G p_aQ 7 <br />