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ELECTRICAL PERMIT APPLICATION! <br />CITY OF EVERETT PERMI'I' SERVICES <br />3200 CEDAR STREET, EVERET i , WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everelt%va.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />1 0 + ckt yl1r r `l� — <br />PROJECT ADT)RFSS <br />SCA •._L It&J C-C 96)1-I / V-cl Bier R0� Vve' <br />Owner Mail Address City Staleop Phone <br />Tenant Mail Address City State/Zip Phunn <br />5 W Vie <br />Electrical Contractor Mail Address Clty Slate0p i'nonc <br />Stale License Number f n Contract Price of Work <br />r <br />Proposed Use of Build• g Contact Person(PlanReview) <br />Description of ppWork to Be Done: o A n1 S' L&ti ia�1 I�P I tQ iy t ✓h <br />�PS`I J�o11 P •-i I S��n<<t_ )����r � Contcn�enco a���l <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE 1 <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />t hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions oflaws and ordinances governing this type of work will be completed <br />wheth,rr specl0ed herein or not. The granting of a permit does act resume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />puiurmance of construction. That I am authorized by the owner of this roperfy to perform the <br />work for which application Is made and I comply with the State Contractors Lew 18.27 RCW and <br />29u.200 WAC. <br />Sign lure Date % 6 <br />'/v'S] J <br />