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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201/—/ 7�Q� <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />fag/r-ia3 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS �Vepe,It <br />iL <br />Owner Mall Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />F0aes V neCA-r-ac Z?szl 138ro,vSE. _C,,dko--•A w-c, 435-2>3-S?a5 <br />Electrical Contractor Mail Address City State/Zip Phone <br />_ oV <br />t�O72C L'LJL� `�/ �ii ON 8 � <br />Stale License Number Contract Price of Wnrk <br />Proposed Use of Building , // Contact Person (Plan Review) <br />Description of Work to Be Done: Ax/ lob' ve I r C , fcV, r ) �'. ��cY ke J'Q'1� ,"' is fced.,k esoE <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 examined this application and know the same to be Irue and f✓�� �` <br />correct. All provisions of laws and ordinances governing this type or work will be completed <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 file <br />performance of construction. That i am authorized by file owner of this roperty to perfoml the <br />work for which application is made and I comply with the State Contractors Law 18.27 RC"' and <br />296.200 WAC. <br />Signature Oate <br />