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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 <br />l� ry r r-rr Mn a wry y 121 A �LV@ZUT k4l,_D <br />PROJECT ADDRESS /� \ I /� I <br />YIN SN1 L1tJ - � YJ�7 l l'�t �i �' ��%�Tf MA, I W"/ Law-, 1111A LjS�2l)� <br />Owner Mail Address City Stale2ip Phone <br />F-1rv\5�3 UNC g51� 1402- 5E LVW_LTr NVILt VVY Llrfl rrT Wf �iK20 � <br />Tenant Mail Addresq city State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />1a9,�07 3191� qz <br />Ci.19 ?A / 4 1,12-5, Ob <br />State License Number Contract Price of Work <br />,5'?c) il r Y? I I A) r n,J <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: /ll, i Vni 4h 1 n 4' Ell ,1J 0 -i �/ �� � M I IV S I � (.,(-A � n tJ <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO rFEE <br />BE IN RACEWAYS, MC OR AC CABLE. -3 b-D <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 becompleted <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 state or local law regulating construction or the <br />perf <br />ormance of construction. That I am authorized by the owner of this roperty to perform the <br />work for w application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296 200 A . <br />oS1�22Z� <br />Signature Date <br />EI- O(D0�- 12C� <br />