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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES 4 _,o_D F <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - Ff+ ' 2t-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECTAD ESS <br />Owner Nail Address Citq Slate/Zip Phone <br />enanl J Mail ss City StateZip Phone <br />3yo9 �%'/ D N&AV4 GFS TIh/R 2e zsz 5 <br />Electrical Contractor flail Address City Stale/Zip Phone <br />a O <br />'D$f41-5 V E- /O— <br />Slate License Number Contract Price of Work <br />Proifbeed Use oftSuilding 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 �9t , v <br />I hereby certify that I have read and examined this application and know the same to be true and <br />correct. Alf provisions of laws and ordinances governing (his p-pe of work will be completed w��y <br />hether specified herein or ❑of. The granting of o pemut does not resume fo give aufhonty to E c' �l ' �2% <br />violate or cancel the provisions of any other state or Iccal /aw regulating construction or the <br />pe"onnar ce f construction. rattan uthorized by the owner of this property fo perfomr the <br />work for o/I I application is r de ar comply with file State Contractors Law 18.27 RCW and <br />296.200 t,✓ <br />i19 <br />Signal --- Dale <br />