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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 />00 �01 <br />PROJECT ADDRESS <br />_ � hoc ord 10/0 � 6wfcl t'o'+ <br />Owner Mall Address City State/Zip Phone <br />Tenant Mall Address City // State/Zip ,�A Phone <br />IXi)G� f✓�I�Y('4oc & f%Z�q.7V4X � 111E L4/(e �eVelli iesjl CWZ5-0 <br />Electrical Co rant clor Mail Address City State2ip Phone <br />� J �2S•3s9.637/ <br />Q 1 i e T q L17Q 6 /OU(� <br />State License Number Contract Price of Work <br />7eic%re l< A f 2p- <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: On -(Pf Q YP e�rJ w ryIce l <br />IA4 re /�k4f),/c t" / G h <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 or laws and ordinances governing this type or work will be completed <br />whether specified herein or not. The granting of a pemut does not presume to give authority to <br />violate or cancel the previsions of any other state or local law regulating construction or the <br />perfomlance of construction. 77tat l am authorized by the owner or this property to petfomi the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />07 <br />Signature Date <br />V J <br />