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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 />�] C <br />/�U 1,) ,f ,I,i,Nc �)rC ) 4)f, <br />PROJECT ADDRESS <br />Eo ceTt j`TI I &Nt?7 ✓;QE4e" <br />Owner Mail Address city State0p Phone <br />Rr)bevVi Nk 616. Pvh eH . <br />Tenant Mail Address City State0p Phone <br />14 to -Lay <br />Co w. ( a i i'Ov 5 . 13 63 D "`rq Li d9,t24, ,.i L) fd- <br />Electrical Contractor Mail Address CI f State/Zip Phone <br />�22fU5 <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: C j1RLC- 40 P 7eC_!-I f 1.1 /ZnUSJc_ <br />0 o-% t-\ . <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 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 />That I by <br />performance of construction. am authorized the owner of this property to perform the <br />work for which application is made and/ comply with the State Contractors Law 18.27 RCW and <br />296.20000�WAC. <br />�k J <br />Signature ' Date' <br />,/ <br />