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ELE(`#�TRICAL PERMIT APPLICATION <br />CITE! OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwei.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />l qtz <br />PROJECT ADDRESS <br />Owner Mail Address City Stale/Zip Phone <br />F/lw64 k)'kl f- <br />Tenant Mall Address city State/Zip Phoae <br />�Uk� `f,U��Cr�r�v14?ems %/, 2- 5. 72%�S <br />Electrical Contractor MailrAddress City State/Zip Phone <br />Lok& 5-5 // 3-6 3 7 <br />Slate License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: /M5TA/U OF SO'— dA)7'7�T� <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 I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances govem/ng this type of work will be completed <br />whether specified herein or not. The granting of a permit does not ppresume to give authority to <br />violate or cancel the revisions of any other state or local law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this roperty to perform the <br />work for which application is made an" 1 comply wiht the State Contractors Law 18.27 RCW and <br />296.200 WAC. Z'� <br />Signature Date <br />oGdB-(G7 <br />