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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 />IAPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />3904 yJ ES i I� LLl1't �T U .\�LVI� <br />PROJECT ADDRESS <br />t 1fiUS so 'SuSt4 ST j'2=ua44 WA ' <br />Owner Mail Address City StateOp Phone <br />tipS 443(-Lf f-2 / <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to De Done: •Y�y l2�� Wrre— UP) 4-r 71AP F9LI (A isox <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 examiner' this application and know the same to be I.-ue and <br />correct. All provisions of laws and ordinances governing this type of work will be completeL' <br />whether specified herein or not. The grantirg of a permit does not resume to give authonty to <br />violate or cancel the pprovisions of any other state or local law regulating construction it the <br />performance of constructon. That I am authorized by the owner of this property to perfonn the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 1/1'4C. <br />r <br />Signature Date <br />Fc;c3-c38 <br />