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P.01 <br />Sep-08-11 03:02P <br />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 />PROJECT ADDRESS <br />7y _ 2i <br />Owner Mall Address City State2lp 4� Phcno <br />f7r-Wk'#-XJ . ! `2 J'/� /�I/ /Li.�t-L <br />Tenant Mad Address City State/Zip Phone <br />�� SvJ Gel J09l (z <br />Electrical Contractor Mail Address City SlalerZip Fhone <br />o z oF- 4,;1-61 <br />State License Number Contract Price of Work <br />Gaift✓L1 - — <br />Proposed Use of Building Contact Person (Plan <br />Review) <br />Description of Work (a Be Done: � G v r7 _ [�_. lPL-f�k C�rv�[�{�(/1� �� �(✓�i <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 3106 <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 govenunAA this type of work w/I1 be completed <br />whether sperrried herein or not. The gianthtg of a permit does not resumo to give authority to Q <br />violato or cancel file provisions of any other state or local law regulaling construction or the <br />perfotmance o/ construclion. T/rat I ern authorized by tho owner of t,lis roperty to perform the <br />work la which apiel effort is made and l comply with the State Contactors Law 18.27 RCW and �I U <br />296.200 WAC <br />a e ate <br />