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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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />.� r=, Ste, � ✓ve-{�- �a �� G1/tY <br />PROJECT ADDRESS f <br />Owner Mail Address City State/Zip Phone <br />- C��>yu,�e 3as S� s�Ma/� w•�y,�e��l W� 9g <br />Tenant Mail Address City StateMp Phone <br />SML Say.�c� �r.� Tiic f/Z/ ZP6 �f St✓ /L3fJ% MCI l ✓,4 ` KO y3 <br />Electrical Contractor Mail Address City State/Zip Phone <br />eM <br />SMc 50c+0 3LO— <br />State License Number Contract Price of Work <br />112 <br />e 62 r/ <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: /Q G✓ <br />A."ICZ GeoljKi r" <br />NOTE: WIRING IN NON -DWELLINGS I:, 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 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 1 am authorized. by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />ate <br />