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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 />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />4l[FsQ4(r- kifONING- 8If SF 1_�v. W11154 WIPY fic�( 7 LA A <br />Tenant Mail Address City Stale/Zip Phone <br />ref N -z-jFP2 f3'g67 1 lAr— /3&5 &6roi ID - Or� sh ZS7-" <br />Electrical Contractor Mail Address City State/Zip Phone <br />P01/1) la_r ��i�3 n� _ 1/00010D <br />Slate License Number Coniract Price of Work <br />Proposed Use of Building 11 11 (2 Contact Person (Plan Review) ' I <br />Description of Work to Be Done: {NS T —CA9 0 QQ T$/-0� �tS S �T�/ <br />GU/ 7�5 <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />i <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 have reed 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 he completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate ur cancel the provisions c f any other state or local law regulaling construction or the <br />performance of construction. That 13m authorized by the owner of this property to perform the <br />work for which application is made and/ comply with the State Contractors Low 18.27 RCW and <br />296.200 WAC. <br />V95�? 3 - /- 2 OOC <br />Signature Date <br />