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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 C—o 7/ 2 -'1 Z <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 Phl <br />Z$o Z VVQ-4_m0CC ,qLA_� <br />PROJECT ADDRESS <br />Qor+- 2(ol0 tJQ-?,,dre' A r,,x Eyyc . WA N1A <br />Ownor Mail Address City start! zip Phone <br />.�L a 01. <br />Calleo� a4oi l.)e:l-A%0'C 11 { &VCrClll WA &;LS-3( <br />Tenant Atiml Address City Sta!vlzip Phone <br />xuc. <br />yv�c.c�or�ald M1lzr -7-1 1 -1 17cirori ALL k SW Sty {o� wR gS?lU(• -70% yd�� <br />Electrical Contractor Mail Address City Slate';) Pnore <br />M61 C70MF ` IDL 9>F- !i9 IUD <br />State License Number Contract Price of Work <br />C o l l e g e Se Sge rvl o,�{ e� <br />Proposed Use of ruilding Contact Person (Plain —Review) <br />Description of Work to Be Done' �-✓� 5"�� �� `"f (�( V 0 I ��g 1�rMyO� � S1A'>�S dWy <br />�GIUcGxfi'e 2 ex)-'+Im`G �cn VU�I4C(,2 I _"-257LCkty. <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 />/ hereby cerbfy that 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 type of work will be completed <br />whether specified herein or not. The granting of a permit does not resume to give authority to <br />violate or cancel the provisions of any other stale 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 I comply with the State Contractors Law 18.27 RCW and <br />296,200 WAC. <br />Signatwe Dale I� <br />$9 <br />