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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 — v✓vnv.everettvva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />w1A %' 20 r <br />PROJECT ADDRESS <br />Ownept Mail Address city State/Zip Phone <br />Czfw) <br />�N✓=!c L/iR/C �100 Ll�lmae.' ie' / LA YPid/ zL1s 2S7 Gih6 <br />Tenant Mail Address City State/Zip Phone <br />Altlg^ ra,rca olwr aa�z—/ Ff1srymq e wl A5N7ZV i.vA. �MEZ-7"2e <br />Electrical Contractor Mall Address City Slaleop Phone <br />C D4 -rSa <br />State License Number Contract Price of Work <br />7Mr71[c-ALtuf%rvl"y/ot�„tf <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done' �.2../.- r Lin P7i• LA :a/ A ci, j e" H •.Fr.._ 64-rL' L; <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 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances govemmg this type of work will be completed <br />whether specified herein or not. The granting of a permit does not PPresume to give authority to �7 <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 wh' h application is made and I comply with the State Contractors Law 18.27 RCW and U <br />296.200 ly�C. <br />7 <br />G� . <br />Si ure Dal / <br />