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ELECTRICAL PERMT 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 />1M,2 J. �. Ede.PPTrN%/�Gd f E/l.4rl �✓P QVzOS- <br />PROJECT ADDRESS <br />Owner Mail Address City State0p �,c Phone <br />;e rij /vlzrlsf 90-A0j- <br />e Mail Address City Stale2lp a _ (hone <br />glee o sor e . a . P OBrO IH4Y//PJ �r yZs 77y-%/8S <br />Electrical Contr ror �A Mail Address City StateOp Phona <br />��� �✓�Jr���� 7W, <br />Stale License Number Contract Price of <br />Work <br />Proposed Use of Suilding Contact/Person (Plan Review) <br />Description of Work to Be Done: NSA/� 3Ut%0 rii d� mar-' e0l rz— //O/Lf a`- <br />��r� /"IZ12 c,ee� fTxf /-/7-os' <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 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 specified herein or not. The granting of a permit does notp psume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance o/construction. That 1 am authorized by the owner of this property to perform 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 <br />