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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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />E o 70 7-00 b <br />-1Gi 35_ST <br />PROJECT ADDRESS <br />loc�� tt4y�v r2r -7ol 3S�` s4 Ea- vc-" (WAI <br />Owner Mail Address city Slate/Zin Phone <br />Tenant Mail Address city Slate/Zip Phone <br />�tBsF2 ( tk 0 L T c 2 :?o Ate^ S Ev-"r—ti, -l2S"Z443-*X.16 <br />Electrical Contractor Mail Address city State/Zip Phone <br />P(2eS7e79s3 cif <br />Stale License Numbar Contract Price of Work <br />St 0 <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: 1. S t ic. Sz n �- ^^oaU \ �" c fin: �� S iw • C S <br />c� dct r}iCi tn. <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. Q <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 )J <br />1 hereby certify that I have read and examined this application and know the same to he We and <br />correct. Alt provisions of laws and ordinances governing this type of work wiN be completed <br />whether specified 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 the <br />performamr - of construction. That I am authorized by the owner of this roperty to perform the <br />work for wl,., h application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />7 Xcn Y e _ -7 2 0> <br />Signature Dale <br />FV70-ogb <br />