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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 — wvvw.everettwa.org [ b 70 3_0 69 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />G,'//jerz7�0,A/ <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City Stale'Zip Phone <br />"-/�%s� c�lec , /�7/y S'7�•�9�/f, nr.�, ,�rilevsl�,/�s u��a- 9d''a7i yasso/- Sri <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number Contract Price of Work <br />S� �rq 4 ��,,, L y S�df C4,54A <br />ProposeA Use of Building Contact Person (Plan Review) <br />0 (' y/� t <br />Description of Work to /Be Donne: C rLN/d Cl�/./ lao1.�e74' ai'xev <br />&7./ NQU/ hPN/ C,%Ze1t,T. ®it[ c44 SacvtS/ /��i K7rt�S Ji/,ti4. <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 Ilia 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 roperlyto perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />9� Ag <br />Sin re Date <br />