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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 />PROJECT ADDRESS /� f� <br />S�e/inan Arty <br />Owner Mail Address City Slate/Zip Phone <br />Tenant Mall Address City State/Zip Phone <br />146me" e eG7-low e— 3603 - Zoo/'°S_ S yLvoamai rA4 �>2� <br />Elactrical Contractor Mall Address city �1 State/Zip /1 3--; Phone <br />/nI: H2 ,�/ ?_ <br />State License Number (V Contract Price of Work <br />0Z�711/C <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: A/e k/ 1te fO ccr t9om 4 2oo <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 heroby certify "hat "lave <br />read and examined "his application and know the same to <br />be true and <br />corrocf. All provlsfons ollaws and ordinances govenrmg ffus type of work will be completed <br />whetltar specified herein or not. The granting of a pernuf does not resume to <br />give authonfy to <br />violate or cancel the pprovisions of any other stet- or local I %v regulating cons:ruchon or the <br />performance of conslrvc"fon. That 1 am aufhunzec' by file owner of fills properly to perfomr file <br />work for which application is <br />made and I comply with the State Confrocfors Law 18.27 RCW and <br />296.200 WAC. <br />Si - ��-o- In <br />Signature ^� Dataa (�� � U l.� <br />