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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 />L Lie s, �n�,� AV <br />PROJECT ADDRESS <br />INK PADS ac Po W 253 EDmoVD5 t%)4 Iva) 2to] <br />Owner Mail Address City State/Lp Phone <br />Tenant Mail Address Lily State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />.#aoc0°o <br />Stale License Number Contract Price of Work <br />4-M plwl k4rkyr\eK <br />Proposed Use of Building /� Contact Person (Plan R view) <br />Description of Work to Be Done: 1`/� Qwire egisll lr�t 1,\oyse' kepleAce Qryi(-e pnyiei <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 speciied 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 roperty 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. <br />I Z 2Z 200 <br />g ature D e <br />1%�(z-IIj <br />