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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 6 a S—O cj <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />C��i06�I a-d� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />nn vu- k2 r sevAp, vw\ <br />PROJECT ADDRESS <br />Owner Mall Address City State/Zip Phone <br />Ltc Z s`�on4Z_ '?g� 6 �Iu_Cei , 2I%ef4 Uty q15 4;9- I`t(( <br />Tenant Mail Address City State/Zip Phone <br />EIe rical Contractor Mail Address City State/Zip Phone <br />�jeo <br />Slate License Number Contract Price of Work <br />cu'(AL\,, N*� ( <br />Proposed Uso of Building Contact Person (Plan Review) <br />Description of Work to Be Done: Y�-Q N� - ( UVA% V1 ik I Pe S CV( <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 thal 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this typo of work will be completed <br />whether specified herein or not. The granting of a permit does riot presumo to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />pedomtance of construction. Tirat I am authorized by the owner of this property to perlomr the <br />work for which application Is made and I comply with the State Contractors Law 18.27 RCW and <br />296200 WAC. <br />Signature Date <br />