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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 J25-257-8857 —www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />(� i �f KUaIA Ll 441- <br />PROJECT ADDRESS <br />� 'I ICkU/�nC` 13ib 13-7IA,;, �r Al it C%I� �1r 98otz q25- <br />S79 JS <br />Owner Mail Address City SlaletZip <br />Phone <br />Tenant Mail Address City State/Zip <br />Phone <br />k'S L led c 2wtir C:ifcle lAworles Ul4 (ig zl <br />a if617 <br />Electrical Contractor Mail Address City State/Zip <br />Phone <br />NCKS� <br />I <br />Stale License Number Contract Price of Work <br />(Plan Review) <br />• Proposed Use of Building Contact Person (Plan <br />I � � W t 4 ` tU <br />Description of Work to Be Done: e` e n; w I I"-' <br />� 2 U✓ l%m a 1�(ine � — — <br />- <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />I <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know (tie same to be true and <br />coned All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a pennd does riot resume to give authority to <br />violate or cancel the previsions of any odior state or local law regulating construction or the <br />to the <br />perfomrance of construction. That 1 am authorized by fire owner of this property perform <br />work for which appi, r n is made and I comply with the State Contractors Law 18.27 RCW and <br />296. W <br />/ <br />� 2449 <br />Signal a Date <br />