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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 <br />E1zoz-l44 <br />PROJECT ADDRESS <br />' isi�a S l 61, AVQ N <br />ue ii,�Ogx j VjOq V�4V VV 9 �a <br />Owner Mail Address City State/Zip Phone <br />-TRAN 6- f41 qc)2 I ► '>A St U1 :--VQn7_4- W A-Gpac)G oIZ-- <br />Tenanl Mail Address City State/Zip -r Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />Z 0Q0 v <br />Slate License Number Contract Price of Work <br />():zA K\c- H uUNt� <br />Proposed Use of Building Contact Person (PI a Re -few) <br />L42s�Z2�`cl0zq <br />Description of Work to Be Done:f�0 �P <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 /alvs and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permd does not presume to give authority to <br />violate or cancel the provisions or any other state or local law regulating construction or the <br />performance or construction. That I am authorized by ttie of+aier of this roperly to perfomm the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RC W and <br />296.200 WAC. <br />T j 2 12, <br />Slgnat e D to <br />