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Fab-16-12 04:36P <br />P.O1 <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.evere*lwa.org C-(24Zo p3 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PNI <br />0?4p/O <br />PROJECT ADDRESS Y 2 <br />.2s? <br />/aA <br />Owner Man Address city state/zip pimm <br />Tenant Mail Address City Slate2lp Pnono <br />Electrical Contrartot Man Address City statwzip Pnotx <br />0tAAZfr1)")14 11 e7 <br />State Licnnse Number IContract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Wnrk to Be Dunu: <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE 18 7105 <br />1 homhy cerfify float I have read and examined this aiwlication and <br />correct. All provisions of laws and onlinanpos goveiriinpp this typo <br />whethar specified herein or not. �he yranung Ma permit does not <br />vio(afe ur cancol the provisions n any other 3S(ale or local law regu <br />performance of c truction. That I am authorized by the owner o <br />work for which a at i is madr. and I comply with tho State Cot <br />296.200 WAC. , A <br />to be truu and <br />ornphd <br />outhortfetly to <br />FEE ek <br />'0dp <br />9 � <br />L IZ02_-o$3 / <br />