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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES 7 — Is- 11 J <br />3200 CEDAR STREET, EVERETT, WA 98201 ((0 <br />425-257-8810 - FAX 425-257-8857 — wvrw.evereitwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS y� <br />Owner Mall Address City State/Zip Phone <br />Tenant (Nail Address City State/Zip Phone <br />Iq2S <br />)i11 ((A(7) �� �' i t� �ir�r 100&2�:ZQ�S720ho es 1- `21k2L, 3 7 7e75'� <br />Electrical Contractor Mail Address City State/Zip Phone <br />ov <br />State License Number //� Contract Price of Work <br />'C�� <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: (A I rl l4 �G i✓PL(.1/LC� _ <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, PAC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be true and <br />corroct. All provisions of laws and ordinances governing this type of work will be completed <br />tvhether speci0ed herein or not The granting of a pemut does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this propeny to perrorm the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296,200 AC. <br />h�— <br />Signature Date <br />J <br />