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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 - mmeverettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />913 33tzo laG <br />PROJECT ADDRESS <br />�GFF dcC'owAIELL q13 33Ro ST EYrrkve,;;�/' ! ✓A 4z5-z5Z-93 <br />Owner Mail Address City Statc/Zip Phone <br />.. ea <br />Tenant / Mail Address city State/Zip Phone <br />tors - 3 <br />a/l�Zi I �7 A65- SG Sjickm "s! W i4 <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number Contract Price of Work <br />Yom, c _ <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: C 96 A C oX <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 I Iravo read and examined this application and know the same G 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 pernut does not resume to give authority to <br />violate or cancel the previsions of any other state or local law regulating construction or the <br />performance of construction. 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 ; 8.27 RCW and <br />296.200 A'AC. <br />its � D Z�L1/07 �1�� - `/ <br />Signature Date / <br />S <br />�j <br />