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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 /> 112 51- vOzE T d15pa <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> UVH <br /> Tenant Mail Address City State/Zip Phone <br /> t3e) r g16Nr ? 11i EV€f-Cr l Fa-3? ivy sc-Lccrze WA- ' 2531b() <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ,6T5� Sq`IOPQ cro <br /> State License Number Contract Price of Work <br /> IL:_lK) 274Nk ES''N2Aa->S <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: i; 03TALL cTh3 Le,w VOUTA-C L_LrbcS ILD(.1 V CSR I y <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. v <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and examined this application and know the same to be true and t4 U � 1 /� <br /> correct. All provisions of laws and ordinances governing this type of work will be completed V V <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 whic application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WA*. <br /> I SO dik' <br /> Sign. re D to C.( <br />