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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 />T\ 7. t^ / 1 IJ <br />PROJECT ADDRESS <br />B m c- � _'zZU� 3 t" A.xr N�_ �v,�a,zcc LU/ G`�LeS <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/zip Phone <br />Electrical Contractor Mail Address City Stale/zip Phone <br />Stale License Number Contract Price of Work <br />C7 \; F L(. % 2" ,rvrn M \z k ` <br />Proposed Use of Building Contact Person (Plan Review) <br />Lt LS- 5 <br />Description of Work to Be Done: <br />k )J cOk M IN PP 2 a ti T_n-\ Arrr t ._I �t Z z s 4 <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 /Ny', <br />1 heroby certify that I have read and examined this application and know the same to be true and I W <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 permit does not presume to give authorily to <br />violato or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this ropedy 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. (J <br />Ing <br />Signature -Date <br />