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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 />APPI iCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECTADDRESS <br />�(rrJO S a7 r�SS /oa S c ��sT Vo.� %r./f gftf <br />Owner Mail Address City StatefZip Phone <br />Tenant Mail Address City Slalethp Phone <br />-64-+��f ALE LY. � l -AVF_ t yE4E-Trl�l� 9 a5a se <br />Electrical Contractor Mail Address City &ate/Zlp Phone <br />C?gpj 14, 650 <br />State License Number Contract Price of Work <br />_j�'U--i%I L. <br />Proposed Use of Building Contact Person (Plan Review) �-✓� <br />Description of Work to Be Done: ' 1�� it O G- A-uh rt� X L S?-t j Cr- 12— <br />�t-0_ F, L C­ II47 14(r d O ST-A-t l_ -TT.A4� LV c-4--f-s <br />tJ 1 ?4.s orzi✓KO(a IIJ FL7'-1_1012iLS <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE c c <br />BE IN RACEWAYS, MC OR AC CABLE. 3 Z — <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 authonty 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 b� 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 />296.6.12000 WWA,C. <br />07 <br />Signature Date _ if <br />/ <br />