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Y <br />T <br />R� 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 />S H o IM &C-A- vale ' <br />PROJECT ADDRESS1 / L <br />V COI RS�u� 'gas i 51= Kvl cwt rs "\ V <br />Owner Mall Address City Slatc2lp Phone <br />Tenant Mail Address City State/Zip Phone <br />VH Pt:, r)Qx zl q viL ,-i yVir- 36v-z65-s?D' <br />Electrical Contractor Mail Address Clty State/Zip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building L� Contact Pe son (Plan Review) <br />Description of Work to Be Done: leC 7r 1 Cq / IN I ✓ f q�' I /q/t0✓X <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />5- <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 pernut 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 />tvork for which application 1s made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />L2 o <br />Si liature Date <br />