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s <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />C— obaa-p� o <br />S9/o A rtalrat€/Z RD <br />PROJECT ADDRESS <br />*/C2 es r (oA1r'r2 v,,77ON <br />Owner Mail Address City Stale/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />tiArc9c i2 t�cy— CLe 7f74r• Sr,(_ 6rf7 I6BTM 51S0 414Ntiw00> 4)f1 `7 go3 7 <br />Electrical Contractor Mail Address City State/Zip Fhone <br />k fA Q-3CI? E- 9 & I 0'P <br />Slate License Number Contract Price of Work <br />5.r D — <br />Proposed Use of Building Contact Person (Flan Review) <br />Description of Work to Be Dom): L,%i /2t NG Al //I ✓S •� <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 governing this type of work will be completed <br />whether specified herein or not. The 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 I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296,200WAAC. L/ <br />Signature Date <br />