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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, E"ERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettvva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />. n 19, W. Mcy lyve V lv-ij De <br />PROJECT ADDRESS <br />iVlurpl�u uU;ld�rill Co pa f--sci 2g4—;&Qfz-* v-A zO3 <br />Owner ` Mail Address City SlalelZip Phorc <br />5a,m2 <br />Tenant Mail Address City Staterzip Plronc <br />/AzS. 33S .� �Sq <br />51,ohornislr` 1e � IVc WA ggOctl <br />Electrical Contractor Mail Address City State/Zip Phone <br />6 M0 H O E I I1b40VJ <br />Slate License Number Contract Price of Work <br />— <br />Proposed Use dif Building Contact Person (Plan Review) <br />Description of Work to Be Done: <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 permit does not resume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or file <br />performance of construction. That I am authorized by the owner of this roperty to perfomr the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />3 15 U <br />nature Date <br />