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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 p <br />425-257-8810 - FAX 425-257-8857 — vmhv.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM c o eO3-o63 <br />y I 0 (J} 15�121� aw <br />PROJECT ADDRESS <br />N V esfirAe,d�-5 <br />Owner Mail Address City Stale/Zip Phone <br />Tenant Mail Address City Slale/Zip Phone <br />H ZS <br />f;0 M rMT E:UC- ( rR �L- IS'Lo3 4.b& --SF MW SZJPVJ WwJ WA Y611 L 36S s)s` <br />Electrical Contractor Mail Address City State/Zip Phone <br />MNE 1 Coo KZ _ <br />Slate License Number Contract Price of Work <br />I DU�'LE x <br />Proposed Use of Building — Contact Person (Plan Review) <br />y <br />Description of Work to Be Done: t '—1 �we <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 />correct. All provisions of laws and ordinances governing tnis type of work will be completed <br />whether specified herein or not. The granting of a permit does not ppresume to give authority to '2 <br />violate or cancel the Provisions of any other state or local law regufafing construction or the <br />performance of construction. That I am authorized by the owner or this roperty to perform the 2 <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW end <br />296.200 WAC. o <br />Signature Date <br />