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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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />/yoz 3f Eve4Ln- Mq(j WAS /Citi(2uLt4F--, 51L,1_r� S <br />PROJECT ADDRESS <br />SrtA064ir' CO. NOZ sf- F(I&Wr OW1 WAjr, Eyartirr� 01q- ?$?a8 <br />Owner Mail Address City State2ip Phone <br />GIuGLLL64t- N07- 5F Evcrtetr vnatl tj4y E(1.racrr�W/f S'8?46 #�5- <br />Tenant Mail Address City State/Zip Phone <br />QD W 5W suc RfIL Mr- I l4n Sr. 14e41 W t )I+ ATIr <br />Electrical Contractor Mail Address City State/Zip �Zf mhone <br />5�7ao0o llJJ "& State License Number Contract Price of Work <br />�/?rTw4r(_ <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: �VtD� �'�k�7�Gr-%P�V�� W��'�� <br />fair AW Ct,0cgAg. � _6<404-40- <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 1 have read and examined this application and know the same to be true and SS•SN <br />correct. Ali 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 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 1 am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCIN and <br />296.200 WAC. <br />Sidnature Date (x <br />L' <br />