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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES Z p Y o <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 />'X231 PIJ6 "C <br />PROJECT ADDRESS <br />i o I4 c%7✓q 4zZ'� L 2'e'-A dde fi/�,CFTitr/>z <br />Owner Mail Address City State/Zip Phone <br />tv of <br />Tenant Mail Address City StalerLio Phone <br />�sfa:r .�iru [a _i3r7' 9/1 .Sio ilia a)w <br />Electrical Contractor Mail Address City State/Zip �,1y e/ _P1ippC. <br />5(4z!ZL,-' z0 b//'Of 1 _o s 10 <br />State License Number Cont act Price of Work <br />611WA G e;,- 5y5/r rw - <br />Proposed Use of Building Contact <br />Person tPlan Review) <br />Description of Work to Be Done. ,�iVS/niC- ', r;pgcF 1- N`lue'0'14' <br />yii r�+�1 c <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />RE IN RACEWAYS, MC OR AC CABLE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I 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 />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 I am authorized by the owner of this property to perform the <br />work for which application is madyand mply with the State Contractors Law 18. e7 RCW and <br />296,200 C.,Signature i Date <br />