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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 />PROJECT ADDRESS <br />Owner Mail Address City �1 State/Zip Phone <br />� J{70P10U/rn� /, �YI&// /� V �le'7/ 1., <br />Te ant Mail Address City�StalerZip Phone <br />�cuinir✓9lan/� /i'ae a P�f i5o3�2 �5Z �% S� 1?01✓ 4n/ G/f!- % 3 7.1_5 G6 <br />Electrical Contractor Mail Address CI State2ip Phone <br />f � <br />State License Number -- Contract Price of Work <br />Proposed Use of Building / Contact Person (Plan Review) <br />Description of Work to Be Done:/LLGCA/n i/Q7Lc0ej '0 �/a1y"L <PrYr,'S <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 state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application z made and I comply with the State Contractors Law 18.27 RCW and <br />296,200 WAC. <br />ign ate <br />