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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES -2 CE <br />3200 CEDAR STREET, EVERETT, WA 982n1 <br />425-257-8810 - FAX 425-257-8857—www.everet.wa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />1�'lvv_r t'r lMbFit-L <br />aF I-5 , N1cqf o: StA0N0valsl4 R NF-r- I'So. of -- <br />PROJECT ADDRESS <br />PuF c ('G WOW:y_'S <br />Owner Mail Address City Statr Rip Phone <br />Tenant Mail Address City State0p Phone <br />\.at t� f o9g2 <br />Electrical Cont aclor Mail Address City Stale/Lip Phone <br />VAlu_l5sc po <br />State License Number Contract Price of Work <br />Proposed se of Building ,1, Contact Person (Plan Review) <br />l Description of Work to Be Done: Pemolc '�1 Cifx`VMG SoMC_ ey-vrcili-� <br />o\liA mLyev -(�t. ltitW delKpvraYy ieaJ^a-'rG {TMVAfn�- dYVlr 1, <br />���iotti aLvLd vWlacc tA+I lrl �l Fotw - -to ex10AjA � lr� S Ingo`^ #2 �. <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 I 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 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 which application is made and I comply with the State Contractors La.v 18.27 RCW and <br />296.200 W.4C. <br />r c <br />Signa ure Date <br />)01- (�%J <br />