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1 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />32.00 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8357 — www.everattwa.org <br />APPLICATIONS ARE ACCEPTEJ FROM 8 P.M TO 4 PM "7 %` 07 <br />eye �( qG/ U.tl,�/3 �v�iz_�s/ <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />IVrrhti Stnr �Iecrr;4 Ig05 Snath Snckcon s( 5eu.tfte V• 114144 aCG-)Aq-ISg6 <br />Electrical Contractor Mail Address City State/Zip Phone <br />kiWI(S F 4 36 L? ` 1_ <br />State+ Licensee Number Contract Price of Work <br />c� �K- Vr6-kC7'•0� Q ���t'' <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: <br />h/4A(P-r_�W7�9C42 )L SG� <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. The granting of permit does not presume to give authority to <br />violate or cancel the pprovisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorizedby 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 WWACC.. , <br />/Z - <br />^'��^nalure Dale <br />