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e� <br />a <br />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 />3J5 LUr'a� T f bl+l� fJY �Tc "3I <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip <br />Phone <br />('ou+jJ 14-3ti 0-2-ZA If <br />Ton nl Mail Address City State/Zip <br />%�brzi;tl �-v✓rB"A-ICPId <br />Phone <br />�3bC_i <br />\/I logo l'Ugo 6!L- AVE Nc ki.-tr-ibTon1 lr�Jti 19��z3 <br />�liS-113� <br />r <br />Electrical Contractor Mail Address City State/Zip <br />Phone <br />NOQZT I+4Vg1)1 l Kc- &35CL) <br />Slate License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: LOI.J V0 crag& Fl et; i4' ,ce <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 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. Tire 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 is made and I comply with the State Contractors Law 18.27 RC W and <br />296.200 WAC. <br />O $ <br />--signature Date <br />