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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 />PROJECT ADDRESS <br />Owner Mall Address City State/Zip Phone <br />Tenant Mail Address city State/Zip Phone <br />�� [� <br />i!-1M.2 ��r ) ?'/' q ��C%20G• "/'z" <br />L'� rJ Z J CA ),A-'J '/ <br />ElectrialContractor Atci14CMall Address city ) statelzip Phone Zltl <br />�70 <br />Slate License Number Contrac Price of or <br />A\ <br />Proposed Use of Building Contact erson (Plan eview) <br />/{ <br />Description of Work to Be Done: (� (I • v'_n i { t Ci l^J <br />fj/ <br />i7 <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 cerfily 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 1 ICI— 11 Z <br />whether specified herein or not. The granting of a permit does not presume to give authority to V <br />violate or cancel tire rovisions of any other state orlocal law regulating construction or the <br />performance of consrrrucbon. That I am authorized by the owner of this roperty 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 />Al /J <br />n ure Dale <br />y� <br />1 <br />