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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 425-257-3857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />% Gavn %ZZa t4ollue F/3 Eye•el7 %�Zo�� <br />y9,1-07Z2 <br />L n :s tti�� <br />Own r Mail Address City State/Zip <br />Phone <br />Tenant Mail Address City State/Zip <br />Phone <br />Electrical Contractor Mall Address City State/Zip <br />phone <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: e_1eciyrc2( (40'�k-uh 4V lnob't( b" <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 goveming this type of work will be completed <br />whether specified herein or not. The granting of a permit does not resume to give authority to <br />violate or cancel the previsions of any other state or local law regulating construction or the <br />by the the <br />performance of construction. That I am authorized owner of this roperty to perform <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />� /(o .vavoS' <br />. <br />alure, Date <br />�ff 0,5 tl -D77 <br />