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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.everettvva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �Z—Q <br />L�0161Z—/Z <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City StaterZip Phone <br />(;gL �I�:c VC) ��o4'DV_�- (VwVjCxxa W\fi- O`qd3S <br />Electrical Contractor Mail Address City State/Zip Phone <br />pLELEL r� In UL <br />Slate License Number Contract Price of Work <br />Proposed Use of Building (� ,,C'onntact Person(PlanReview) <br />Description of Work to Be Done: l" rt�Wa L�u� L�� ^� ^ I Z� u� <br />C` rc,�_)-It­s Ck' 1es ecj t 1S`0-WM!� rcv; f &0 � Y� <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, h4C 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 />correct. 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 pre-,ime to give authority to <br />violate or cancel the !provisions of any other stale or local law regulating construction or the <br />performance of consruction. That I am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RC W and <br />296,200 WAC. <br />Z�q <br />-'[lure Date <br />