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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 <br />x <br />PROJECT ADDRESS 9 711"Z�)1"EP <br />Owner Mail Address City Stat'�!Zip Phone <br />ktd .lzL_sc 7720 L�c�e�r l�� vecc 98020 yZs-�/�b• Sao/ <br />Tenant Mail Address �/� City State/Zip Phone <br />(/HNL Ece.cTk/& iDq//1020410s�el 44-- �✓cPEtT 9S&/ 54z -,Z -/A <br />Electrical Contractor Niail Address City StatelZip Phone <br />4 LCG7c12loLjD Sc .ce!) <br />Slate License Number Contract Price of Work <br />/)/44ja F/flCTdl e /rUC— <br />Proposed Use of Building Contact Person (Plan Review) <br />Description ofWork to Be Done: <br />NOTE WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. / <br />S i SO <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 r I heroby certify that I have read and exantinod this application and know the same to be true and G�' O — L n <br />5 correct All provisions of laws and ordinances governing this type of work will be completed <br />whether speciried herein or not. The granting of a permit does not �resume to give authority to <br />violate or cancel the provislons of any other state or local law regulating construction or the <br />perfomrance o nstruction. Th I am authorized by the owner of this property to peAonn the <br />work for whi �bplication is nr a and 1 co ly with the State Contractors Lmv 18.27 RCW and <br />298.200 W C <br />Sig to Date <br />