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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEPGTT, WA 98201 O <br />425-257-8610 - FAX 425-257-8857 — www.everettwa.org <br />C o5io-ia <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />2-7 e. re_re f <br />PROJECT ADDRESS <br />Bl�( /TRN40E,/✓J j%tj f,n ercto g-yere f WA 9P�zy <br />Owner triad Atldres� City State/Lp Phone <br />Tenant Mall Address City State/Zip Phone <br />raReeitj Phill E7g&� �!!or 3�7 <br />- 33-7f <br />Electrical Contragor �ress Chy State2ip Phone <br />C7REFHEC 932cw 2,3vo <br />State License Number Contract Price of Work <br />(IOI61 el _ <br />Proposed Use of Building ,�// � Contact Person (Plan Review) <br />Description of Work to Be Done: J • 1 z.-)6; tr e C/e G &md Z <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE�7� <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVE RETT LOCAL SALES TAX CODE IS 3106 <br />I hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances govemu,g this type of work will be completed <br />whether specified arein or not The granting of a permlf does not nresurne to give authortty to <br />violate or cancel the pprovisions of any other state or local law regulating construction or the <br />pone"'"ance of consWotion. That/ am authorized by the owner of fhis prapeRy to perform the <br />work for which appiicati0r, is made and I comply with the Stale Contra efors Law 18.27 RCW and <br />296.200 WN� <br />Signature tuate 11'— <br />