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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 C� ( Z -61 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />I <br />� y3 � IZactcv�{' <br />PROJECT ADDRESS <br />y.21 <br />35 <br />DOA104! 136(,AJZ V31 <br />12(Vru.4r 91/ <br />?/'0 <br />Sf <br />Owner Mail Address <br />City <br />State/Zip <br />Phone <br />Tenant <br />Mail Address City <br />State/Zip <br />y�1' Phone <br />&.- pgik Ix <br />&(/ e0 EU <br />W2e/ <br />PZS .7/*/ <br />Electrical Contractor <br />Mail Address City <br />Stale/Zip <br />Phone <br />fkt/ a /X2 C P <br />State License Number <br />S)CR_. <br />Proposed Use of Building <br />Description of Work to Be Done: KEPL &I S Fe rzv(CC <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />li blmouaua- al l4a <br />Contract Pri0A( Work <br />Contacr,Eprrp7m ffIanReview) <br />io �rt.(GG v1A6 491P <br />I 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 presume to give authority to <br />violate or cancel the previsions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this roperfy to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC.. i If <br />FEE C � <br />:EliiZ-05�7 <br />