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F------ <br />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.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />30)S iri/D2o 2iry-fires;»q A✓< f✓cwr.T cJ��G 9dzei <br />Owner Mail Address City Stale/Zip Phone <br />Tenant Mad Address City State/Zip Phone <br />20 G 9 /v )ToS <br />2/ Ear. r.•�. f90� ?G �ffr JtJ j 0"r/./u T�fRor� t✓S ?Fogo3 <br />Electrical Co actor Mail Address City Slate/Zip Phone <br />C u21 -, I o SY J r^ ^,/ 000 <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Descripllon of Work to Be Done: (�w.o .�-` r3.•• �'��"•� C`'�� £�'�• i Q`K a' �'� <br />NOTE: WIRING IN NON-DW ELLiNGS 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 epplicatior, and know the some to be true and <br />pl - o2�T <br />correct. All provisions of laws and ordinances governing this type o! work will bo completed <br />whether specified herein or not. The granting of a permtl does not )resume to givr authority to <br />violate or cancel the pprovisions if any other state or local law regulating conslrucb�n or the <br />performance or constmction. That I am authorized by the owner o! this property 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 <br />Signature cj <br />Date <br />