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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />.125-257-8810 - FAX 425-257-8857 — www.everettwa.org J - S _ it` <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 0:)9 <br />1-7 r/L Poll- A-v , '�vcrctt LEA 9I toy <br />PROJECT ADDRESS <br />KIi v C-Vr Ct{ <br />Owner '—t�- Mail Address City State/Zip Phone <br />Tenant Mail Address Ciq' State/Zip Phone <br />� E1e,F* S0o5 3r,.1 Agc, S S� ttj - wA 9YI?q 2t* 1bL--3 <br />Electrical Contractor Mail Address City StatelZip Phone <br />Nr,ia0C"'98a K6 4l, (o0 <br />Stale License Number Contract Price of Work <br />L;6,r= <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: Li <br />/t.t/r Ir V-' Gti .� -� S"r Ala Ka. C rUnr Cr",J <br />—7 <br />%, d jr.a.Lb TA' Nib <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 I IlC <br />1 hereby certify that I have read and examined this application and know the same to be true and L 1. I V ✓ .-U Z p <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. Tho granting of a permit 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 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. /J f <br />Lam= ✓(.,��_ Uale <br />Signature ate <br />