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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 6 -a --?- d 6 <br />E 06n6-i,�� <br />y7) 5- 33=' f G tJ <br />PROJECT ADDRESS <br />C o('oy o to <br />Owner Mail Address City Slate/Zip Phone <br />Tenant Mail Address City StatelZip Phone <br />3` ELr-c,(ZLcf rNc. IZZ /NVA Z2' 1-f LynryWool a/H 9R687 (H2s)7g905Z <br />Electrical Contractor Mail Address City State/Zip Phone <br />` pFL E) 9N4TF�— <br />State License Number Contract Price of Work <br />Proposed Use of Building / Contact Person (Plan Review) <br />Description of Work to Be Done: Ire new i!41e �t—�5l Ger1fL <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEF <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify (hat 1 have read and examined this app/icafion and Wrow the same to Le true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether speciried 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 file <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which application is made and/ comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />-2 7- <br />��4a6 _ <br />ignatu a Date / �j%✓rY <br />