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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 ACCEPTcO FROM 8 AM TO 4 PM <br />S6 <br />PROJECT ADDRESS <br />Fxmw AW+ b 3 DOSE eft WA %;0 <br />Owner Mail Address City Stalc:_o Phone <br />tenant MadAddress City StateZp Phone <br />�s yo �1►5h F.Ieda 825 S StacN SI` Std#4 LAA gSl3y I)COWS <br />Electrical Contractor Mail Address City state Zip Phone <br />SVDVYW02! Nl 6DO,w <br />State License Number Contract Price of Work <br />i . 4w<<1Ii4 iryS Sri mor►yi%el- <br />Propos d Use of Buildirij Contact Person (Plan Review) <br />Description of Work to Be Done tim LXV�_144-M,� (AMXf�&e 614folrAiMiQ <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. r O <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 - J <br />1 hereby certify that I have read and examined this application and know the same to be true and 20� _ �ZZ <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein ornot. 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 regulafing construction or the <br />performance of construction. That 1 am authonzed by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Si atur Date <br />M., <br />