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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 - vrivw.everettWa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />_N r^ Th `IGn G, wy; cr , On- F_ vJEr1L1-7 78ao3 `fas-si <br />Owner Mail Address City State0p Phone <br />Tenant Mail Address City State/Zip Phone <br />yyLrLL.gK-C 1313-2 -5C_-;60ST ne"C'VAC— w/t 9toos dL-6-793F7 <br />Electrical Contractor Mall Address City Stalelzip Phone <br />GV7 rL tz- I (-I 7L —vf' wo -- <br />Stale License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Doscription 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 1 have read and examined this application and know the samo to be true and <br />correct. All provisions of laws and ordinances governing fills 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 1 am aufhonzed by the onmer of this property to perfomr file <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. j <br />x A <br />Signature Date <br />FI1GS- ILt1 <br />