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ELECTRICAL PERMIT APPLICATION .41 <br />CITY OF EVERETT PERMIT SERVICES 3_ Q4_ 1 z <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.(,. g <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Owner Mail Address Clty Slate/Zip Phone <br />'iv) r- ��� t r t"f' �S 'mot � r-/1 4,10JI Le •9 <br />Tenant Mail Address City Slate/Zip Phone <br />T I \ i , Linrsac A P .s -, 14"�i` S�-:)Il�b .1 1ir'� 1..J9 <br />Electrical Contractor Mail Address City State/zip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person/(Plan Review) <br />Description of Work to Be Done: 'I S C Is i 7 (�1 icad In C. <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 1 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 specdled herein or not. The granting of a permit does not resume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />perfomrance of construction. That/ am authorized by the ownerof this roperty to petfomr the <br />work ontracto <br />for which application is made and I comply with the State ContractLaw 18.27 RC W and <br />296.200 WAC. <br />Si na . re Z Date <br />�51 <br />'1% <br />