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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 B AM TO 4 PM DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />PROJECT ADDRESS <br />Owner Mall Address City State/Zip Phone <br />Tenant Mall Address City Slate2lp Phone <br />LM SI��, 2 �wY �y S � rM TVAJ, w4�s2�33i� Electrical Contractor Mail Address City State/Zip Phone <br />Alley -CS SP61 2ZC <br />St.at6 Licens7Nber Contract Price of Work <br />Lu1 / R,1V�-(tic <br />Proposed Use of Building 1 . (I(n► 2 I//IJ Contact Person (Plan Review) <br />Description of Work to Be Done: 1 A 5 / r-`�' ` ✓ C j `-�-�" ` 5( �4 / <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 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 roperty 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 WAC. <br />Signature Date <br />S <br />