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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 —�' -0 7 <br />( v7� 03 <br />301 n1U�i\;ice Q('. <br />PROJECT ADDRESS <br />`Xy',Ac ,mil l��n,try�,�0 1� ,x 3a%li Ev�ce i G��13 lob'�3o_`��41 <br />Owner Mai Address City State/Zip Phone <br />Tenant n ail Address City StalelZip Phone <br />'S ,S' C''rf C_ ` ® a7$ S-'-0 i_rvSh 17) %")`133Y. 7� . <br />Electrical Contractor Mail Address City State/Zip Phone <br />SNoNoE'S-' IIC) 311,v)0b <br />State License Number Contract Price of Work <br />Proposed Use of Building (� Contact Person (Plan Review) <br />Description of Work to Be Done: \,,'J <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 <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 pomnt does not resume to give authonty to <br />violate or cancel the provisions of any other state or local late regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this property to perforni 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 />Sig lure Date <br />1c! <br />