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ELECTRICAL PERMIT APPLICATICN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-19810 - FAX 425-257-'u857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City StateMp Phone <br />(3GO] <br />/61 oz3 kinds A) (A cl?3YG 26s- srioy <br />Electrical Contractor Mail Address City State/Zip Phone <br />\1AP�=LE_ *GLA2-DT 300 <br />State License Number Contract Price of Work <br />jI -hCV) <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: fjlYe G �C'I7'Of, r::�o-\Fa! jf F _fNtw� <br />71 - wit <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 />/ hereby certify that I havo 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 permit does not ppresume to give authority to <br />violate or cancel tire revisions of any other state or local law regurating construction or the <br />performance of construction. That I am authorized by the owner of thls property to perform the <br />work for which applicat,,n is made and I comply with the State Contrec ors Law 18.27 RCW and <br />296.20/0 WAC. <br />Signature Oate <br />o2— <br />