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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 • DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />PROJECT ADDRESS <br />1-)rz( t-,) 1 C)V1 LOA (1-a EN 0 C-wyf,+AAUw C�SZOIlt) (L{ �=� <br />Owner Mail Address City State/Zip - Phone <br />Tenant Mail Address <br />City State/Zip Phone <br />Y1 �YCG\ �CLC1` IC _1_1 Or; vi )Yyu\ ok ')t I _yo v) Iyi6 `1 20 ► t'�z5)155 3 <br />Electrical Contractor Man Address Ciry State/Zip Phone <br />State License Number Contract Price of Work <br />01,k+0yItz 0Q._ �I1\4e OL1ke1'V14F <br />P_y- <br />Proposed Use of Building Contact 4son (Plan Review) <br />Description of Work to Be Done. 'jC i t 1 \ <br />�LC�r`���\ Susi�w� {r 1�PxvcX a LI i )i l� ` <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 />I 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 permit does not resume to give authority to <br />violate or cancel the provisions 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 I comply with the State Ccnlracicrs Law 18.27 RCW and <br />296.200 AC. <br />q9 <br />ill <br />z lwhzoos <br />Si nature Date <br />