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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 — xww.everettwa.o!g r <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C <br />PROJECT ADDRESS <br />E...t� <br />,4'4 1' <br />Owner Mail Address City State/Zip Phone <br />J a+tn ' Y--C <br />Tenant MailAdd ss M City Stale/Zip Phonc <br />Electrical Contractor Mail Address City State/Zip Phone <br />G6 S �' 93(1 Rk _-moo_ <br />Slate License Number Contract Price �ofWork <br />vat. 11r,a r� A a --a �1 <br />Proposed Use of Btfilding J ff ] �Contact Person (Plan Review) <br />M <br />Description of Work to Be Done: Zn ti I - �h `WLa 9 Iy 1 l-r r"j (�/o A S 47 <br />NOTE: WIRING IN NON -DWELLINGS IS REOUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 have read and examined this application and know the same to be true andl O (� I <br />correct. All provisions of laws and ordinances governing this typo of work will be completed <br />whether specified herein or not. The granting of a permit does not resume to give authonty !o <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of thisproperty to perform the <br />work for which application is made and/ comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />. <br />Date signature <br />