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U <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 a 7 a <br />E©Goa-o77 <br />3oS 54� eyc,, i-J- A41 11 wit 1 <br />PROJECT ADDRES11 S <br />31 Ccstc..T�v LLG /dbQ/ A4.� 54- 3GAleAeUiz- WA 4)6-0 '4 <br />Owner Mail Address City State/Zip Phone <br />i� sE c..�Jl pllwty W4 ai��oFr <br />Tenant p Mail Address city State/Zip Phone <br />a:,, .Z3y /63idr_. e / G e VVA UO73 '/6� G'T3 <br />Electrical Contractor Mail Address City State/Zip Phone <br />M/Cuo- <br />State License Number Contract Price of Work <br />'¢�1-ate,-�---%r `b-ti....dc�.. /►/wee-� <br />Proposed Use of Building 1Contact Person (Plan Review) <br />Description of Work to Be Done: "r✓' fz / / LV' w r% %r� F� N -r sh'hj npgs.,q <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 />cormct. 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 resume to give authority to <br />violate or cancel the provisions of any other stale or local law regulating construction or the <br />performance of construction. That/ am authorized by the ownerof this property to perform the <br />work (or which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Signature Date <br />0.)-77 <br />`jz ZLI <br />