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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 425-257-3857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�jw <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City S131e/Zip Phone <br />wa��'rf o / d.vd Sf. Sk,4,7CLAOO� r .1/9-- <br />Electrical Contractor Mail Address City Stale/Zip Phone <br />4 <br />ireaeA <br />State License Number Contract Price of Work <br />i�D�t,-lP,+ <br />Prdposed-use of Building � Contact Person (Plan Review) <br />Description of Work to Be Done: 1aak ra >" A— in avr( ' <br />jfJilc.L. U�'!Q DcJ�f_� 1f.r1 CJYIP lruG-E tJL7�IC1ra�—� <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 />I hereby certify that 1 fiavo read and examined this application and know the same fo be true and <br />correct. All provisions o(laws and ordinances gavemung this type o(work will be cormpleted <br />whether specifled herein or not. The granting o(a peanut does not resume <br />to glue authonfy fo <br />violate or cancel the provisions of any other state or local law regulab'ng construction or lfie <br />performance of cons mction. That I am authorized by the owner o/ thus roperfy to perform the <br />work far which application is made amd 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 A . <br />0�111115�110 <br />bign __— Date <br />