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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 />39a9 2t,Lr_.�_e Ave — <br />PROJECT ADDRESS n <br />Fps=ca,r C Iait __ Na4r A-ftf fluff dueI?�-T W+� 982D1 Yt5334 5485 <br />Owner Mail Address Cdl StateZp Fhone <br />Tenant Mail Address Cdy State0pp Phone <br />�ICNTLtIf Ll C 1300 f)1G2rItc i1Q�Ek RCAwY agoo I FuERF7r lid- 7524r '1Z5.7"75_-'_7'1L( <br />Electrical Contractor Mail Address City StateZp Phone <br />611tar! •ak 9K 6 7"C <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description if Work to Be Done. a ^'� o �1L..<1 lt15Ta l-4-A 7O o <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 />Iv meter specified herein or not. The granting of a permit does not presume to give authonty to <br />violate or cancel the prpovvisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC <br />Signature Date <br />