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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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />� DZ-j l�tC�1'c 1 EVk �A)A 9--6ZU1 <br />PROJECT ADDR S <br />j� o A'1 ( b16 <br />VcCA <br />(° J;t, [ . Llion <br />RoLo Fyu-e <br />-I I,UIR-gzu I (4Z5)339- <br />Owner <br />Mail Address <br />City <br />Staleop <br />Phone <br />Tenant <br />Mail Address <br />City <br />Stateop <br />Phone <br />4,n; 1rn\ �ACittC <br />2?� 1 �AIi YYLta <br />St r <br />yeYQ W!A q 701 <br />Electrical Contractor <br />Mail Address <br />City <br />stateop <br />,SON I -F � 2 t I N A <br />�'l l (�S. <br />State License Number <br />Contract Price of Work <br />�ieAIra( :Fa( 1� \%l.l <br />A n <br />Proposed Use of Building <br />ConlaL Person (Plan Review) <br />Description of Work Done: <br />11 ,,` <br />I� I ISk(.l-I�ICJ.I On <br />J52 <br />Gi 16IA) 1 IAI (Qq <br />P <br />.tLo,B�e <br />Sl? % 1.1 I::, I <br />a CJ 1. <br />Y ' 1 l-1 <br />-lz - <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 1 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 presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of constfuction. That I am authorized by the ownerof this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.20 AC. <br />. innaurte Date <br />