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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EV=RE FT, WA 98201 <br />425-257-8810 - FAX 425-25"i-8857 — www.everettwa.org <br />APPLICATIONS A1.E ACCEPTED FROM 8 AM TO 4 PM <br />C vacdl( t_jA C(`rSz_(2�-I <br />PROJECT ADDRESS <br />n - c:I -Zee_) Dot A j L c>(19— i LA_)zS�z' <br />Owner Mail Address City State/Zip Phone <br />`;o n vt-1a <br />Tenant Mail Address City State/Zip Phone <br />' [-' 1��e(SEvI Ctej(;C 231Z4 9rif61I�U�W L tl1Nw ^J 1�)/� � �G 4t5 775 I1`(1 <br />Electrical Contractor Mail Address City I GI / State/Zip Phone <br />K �rTer I Lt�> P III /1d o <br />Stale License Number Contract Price cf Work <br />��CLiY�r� I L.Jftv�Sn �e-1 <br />Proposed Use of Building 1 Contact Person !Plan Review) <br />Description of Work to Be Donee e4r-j Z ZOVUI�" �IC Coca-5 tv Vtev rXi�eS [«'I"l}ee- <br />�� ^� cI[Lkir�( i✓l L..c,l�ri` %e( VLew �c�5(-�rl� 1�I✓t�ot.5 Geabit� z <br />�' n ��,-,,,rn<..m✓1�"`C�t-tP��j wl'��'l t-t'.W 't'inllyCf��7. <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 />1 hereby certify that I have read and examined this application and know the same to be true and r'-1 i, -- I <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 regulafing construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Lew 18,27 RCW and <br />296.200 WAC. <br />Signature Date <br />