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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 />30-5- 01a cG uv <br />PROJECT ADDRESS f <br />Pc� Rty <br />^ �7 170 U <br />YtC 1!/4e�lDai��/ l ti f aedtsl Mu fc: <7'y0j <br />Owner C Mail Address ` city State20 3/9 596r � §b <br />Tenant Mail Address city StateZp Phone <br />Sivas,--� r�'to-g7- Jr,,:kra�cc-v¢ Rr�o3� S>2 11 <br />Electrical Contractof Mail Add ess city StateZp Phone <br />520.cU o <br />State License Number Contract Price of Work <br />�1 j f' `5-5 / CiA-i t C ✓ ! � Y r'1 \ �l CI r� <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: MU U L-, fA:/' <br />SL9r' <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />FEE <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 E m0 _ <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 1 comply with the State Contractors Law 18.27 RCW and <br />296.290 WAG. <br />Signature Date <br />