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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 — wvrw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PRCJECiADDRESS <br />Owner Mail Address City State/Zip Ph,,, <br />Ua L44{-- <br />l <br />Tenant Mail Address City Slate0p Phone <br />A $/-k, tjletj(rt`e- 19e)5` S SgckSoA Sf C-O& 9�ILty <br />Electrical Contractor Mail Address City State/Zip Phone <br />i <br />W-MK F, (3600 6 1 VZa <br />Stale License Number Contract Price of Work z-e6 <br />1-�u,olrl B;�s �Sa-�tfS3 <br />Proposed Use of Building Contact Person (Plan Review) <br />�"mo <br />Description of Work to Be Done: ' o -F t� le c 1•`«. li, as-- 6/"9 grL2 d <br />tLUyQ Mr�c. <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 hereb certify that I have read and examined this application and know the same to be true and <br />correctY All provisions of laws and ordinances governing this type of work will becompleted <br />whether specified herein or not. The granting of a permit does not resume 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 I am authorized by the owner of this pproperty to perform the <br />work for which application is made and I comply wilh the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />/X(,e/ 4 / dE <br />gnalure Date <br />taus -i K G <br />