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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 O8 <br />425-257-8810 - FAX 425-257-8857 - w v v.Pverettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L �12 75 <br />C <br />PROJECT ADDRESS �j <br />2-OID'� ��hGuC�"e iN�o, %97U/ <br />Owner Mall Address City State/Zip Phone <br />Tenant Mail Address City Stale/Zip Phone <br />Electrical Contractor Mail Address City Slate/Zip Phone <br />` /y 6 a o <br />Slate License Number Contract Price of Work <br />Tp- C,C lC -{--c 'C/� - = 6 ff l-2c lr� GRWr_� S <br />Proposed Use. of Building Contact Person (Plan <br />/Review) <br />Description of Work to Be Done: ftiG�d C �C C tr'e f / /� 6 W <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 have read and examined this application and know the same to be true and `6 2 �S <br />correct All provisions oflaws and ordinances governing this type of work will be completed <br />whether specified herein or nct. The granting of a permit does not presume to give authority to <br />violate or cancel the pprevisions of any other state or local law regulating construction or the <br />performance of constriction. That / am authorized by the owner of this property to perfornt 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 />Dale signatureture <br />