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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 State/Zip Phone <br />aoS�c �r�rref�/n�//lJu y yas <br />et l� rT c�F tT �� MaAddress r /� �d Y/c Id 19 arz/i06 �l� -Phone <br />S/U iU <br />Tenant <br />�J / W/7- S ) <br />rOT��fiU �n /YQ66 S4- WA (?,YA3,)- IQ-%13J <br />Electrical Contractor Mail Address City State/Zip Phone <br />f PoiC6Ao,U,[I 4 a`f9,eo <br />State License Number Contract Price of Work <br />o <br />ano <br />Proposed Use of Building ( J( Contact Person (Plan Review) <br />Description of Work to Be Done: 5 w 11_6 I � l�l cw m an <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 specirled 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 />perfomrance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RC W and <br />296.200 WAC. <br />AA <br />Slgna ure D to <br />F <br />