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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 7 _ 6 —/ D <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org 067-012 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />—WSJ 6 uc_ <br />PROJECT ADDRESS <br />J11c��1=,�NCS m PtR�ti L i7 �3 y2szsz �, <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />'��Ss) IJ ��FL p. o. may. S �\10 ET v�A ` 3ZALY2S-33S _ <br />Electrical Contractor Mall Address City Stale2ip Phone <br />r,eAs(s<T-�t�22."r -- <br />Stale License Number Contract Price of Work <br />fAt Is 10.cN'C-IC <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: A LTA 2F O InQ 6-Y)i10`.JC ru <br />NOTE WIRING IN NON -DWELLINGS IS REOUIRED 1-0 FEE <br />DE Ihl 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 laivs and ordinances goveming this type of wonr will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authonty to D / <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That fern authorized by the owner of (Iris riroperty to perfoml the / D O <br />work for which application is ado and f comply with the State Contractors Law 18.27 RCW end <br />296.200 WAC <br />g� <br />a <br />SlDate <br />