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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 <br />:) 3U2 f2CX'L C��LI-1 &4F 1 =/Fj( fT f(.iA <br />PROJECT ADDRESS <br />1'°" oI Gay St�t <br />Owner Mail Address City State/Zip Phone <br />/NJ4 �_g-'N�' <br />Tenant Mail Address City State/Zip P one <br />2�Gi <br />Electrical Contractor Mail Address City SlalelZip Phone <br />tVAA,6uC-(_q'42-T0 1 3,qa).« <br />State License Number Contract Price of Work <br />sr,011 <br />Proposed Use of Building Contact Person (Phan Review) <br />Description of Work to Be Done: �254G 'k �MIk1M <br />ri <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 govemmg 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 />performance of construction. That I am authorized by the owner of this property to perfomr the <br />work for wh'ch application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 C. <br />Si ature at <br />