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I <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 10 -10-Q7 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org 870 7/ c-Oqf <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�ct VA SC` Sl �CI <br />PROJEJT ADDRESS ffj <br />F)EJbE � C liu. -Clh 7506 relEcx`n PC'1 Eyz('2+4 1 alii <br />Owner Mail Address City State/Zip Phone <br />-1A�- 3-6 -*,,>i6 <br />Tenant Mail Address City Slate/Zip Phone <br />C �t YIEV_, <br />Electrical Contractor Mail Address City State/Zip Phone <br /># lC,(`CC.Eti <br />State License Number Contract Price of Work <br />tZ«L <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: <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 true and <br />coned. 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/ am authorized by the owner of this property to perfomt the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296,200 WAC. <br />i <br />Signature �� —' � Date <br />'i to - 0 L',[9 <br />