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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 3 <br />425-257-8810 - FAX 425-257-8857 — www.everethva.org UD$'03...-1152 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />(!7 —15 1 14) l/L ///I/0 1012. <br />PROJECT ADDRESS <br />Frf)/'l/ Ewlf% 79�93 J1//d'iliNh D2 v£ FT7 AJY9. 9 � <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />I3Fr DIN/Iv r1rr7 P) %;1M 7/1y 1 ytivr<enO U/A- 9yq) 20 2S/-2/n 0,/ <br />Electrical Contractor Mail Address City Slate/Zip Phone <br />IRFF D,�n-r 93z c L 43z06 <br />State License Number Contract Price of Work J <br />Proposed Use of Building ' Contact Person(Plan Review) <br />Description of Work to Be Done: 1 %F t%) SF///?Vl�l- (.MFTF /L 4— P4AIC&) <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 examiner/ this application and know the same to be true and (✓J 5 <br />correct. All provisions of laws and ordinances governing this type of work will be completed C <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the previsions 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 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Date <br />