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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 />'iOJ— <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />DZj� 1/22,f 30I7 Z<5_ n�4)a ,�l/E�'7I�— ar4� <br />Tenant Mail Address City State¢ip Phone <br />C �7Er66 %AlC- _224 1-2r-974r7 i�.air.�yez= D�9 5saz.F yz�yFf9Cov <br />Electrical Contractor Mail Address City State/Zip Phone <br />Slate License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: �s A2!Z 5; <br />.4a"77if34e- �' <br />r <br />�it <br />,�✓i„i�f2y ���Q ". — D.y GSril7�✓� .4f-r�ia-�/ <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 oflaws and ordinances governing this type of work will be completed T^! O p <br />whether specified herein or not. The granting of a pem it does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the <br />perfomrance of constmction. That 1 am authorized by the owner of this roperty to perform the <br />work for which application is made and I comply with the State Contractors Law 16.27 RC W and <br />296.200 WAC. <br />Signal u ate <br />