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ELECTRICAL PERMIT APPLICATION <br />CI TY 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 />— <br />I�(OZ S Fyii ,Enr, eAL(_wn li3vS <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />C.tNfv�fjol�l WoZ Sr EQV -T•7 f0.4LL_ (04 4�B2�u <br />Tenant Mall Address City Slate/Zip Phone <br />Zo 6 <br />,lctr"t�5w� rc�wts/n�c 07i2-60i-Qf�P1w4-y rzDnkf-Ds WR 7?0eo 106 <br />Electrical Contractor Mail Address .Ei (7 Z City State/Zip Phone <br />Stale License Number Contract Price of Work <br />E—` L &-t L_ ohi t J �Z '�T' ( . <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: <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 provisions of any other stare 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 a lication is made and 1 comply with the State Contractors Law 18.27 RC W and <br />296.20 C. <br />Signature Date <br />FN'OP-Ito <br />