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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-2F7-8810 - FAX 425-257-8857 — www.everettwa.org _ <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />3a_o2 AencilarJ Al? <br />PROJECT ADDRESS <br />99y1A Q IAZ6,I-�iN.s�/ 3ct�2 �Qor��r.%� 0� Eiicr.7% 41)14 `% 0 / <br />Owner Mail Address City State/Zip Phone <br />Tenant Rlail Address City State/Zip Phone <br />3 /37 W—C Sf Set',> XI 4.1-9 �fr�y" YZry 7 7e�1 <br />Electrical Contractor Mail Address City State/Zip Phone <br />PA5,r3E931P7 Cxj <br />State License Numbrr Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: <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 end 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 )resume to give authority to <br />violate or cancel the previsions of any other state or local law regulafing construction or the <br />performance of construction. That I am authorized by the ownar of this roperly to pedmrothe <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and O <br />296.200 WAC. / <br />Signature Date <br />