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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 />j:tiS 5 �. E✓fiLC%� Nlq�L w4y <br />PROJECT ADDRESS <br />GRt�✓{ E plA2�, i;q /'rpDC2 mf* wf <br />Owner Mail Address city State/Zip Phone <br />Tenant Mail Address city State/Zip Phone <br />f✓Af'A"V4t 5/6"/ ewW / 2ff K51yf2' SF49n`_ W� q(fid q &j 7f.2-O jdp <br />Electrical Contractor Mail Address City StaleOp Phone <br />WP, f/0k03Iiv vf.ep <br />_ <br />State License Number Contract Pdc3 of Work <br />.grrw Z, mg,'-dor'l <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: /N,'74GL 7vB SI1yac r4ef / G[r4'4INr !Q WI)u 5/4✓1. <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 />I 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 p visions of any other state or local law regulating construction or the <br />performIn.e o onst ction. That I am authorized by the owner of this property to perform the <br />work for ethic ppli lion is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC <br />Date <br />Sign tire <br />�a") <br />