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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everetlwa.org s _ 2 -02 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM E r7 <br />PROJECT ADDRESS <br />FD�N U ESTME NTS <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City Slate/Zip Phone <br />SuMmIT F-( ku INC Glna `tQs-r 5-r- NQ <z-Mm mn LA 9'629-1 <br />Electrical Contractor Mail Address City State/Zip Phone <br />r-XtGI o 6 0 1_-L & �lti5 30� 515� <br />State License Number Contract Price of Work <br />pyYLCX <br />Proposed Use of Building Contact Person (Plan Review) n <br />Description of Work to 9e Done: Cj 1 �_E NEW DU?LCx W - U �\ P\CrE GUo <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 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 previsions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and (� <br />296.200 WAC. / X <br />/ V <br />S-)2-ci8 V <br />— f Signature Date <br />