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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 — evww.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM\ AM TO 4 PM 8—D 6- 07 <br />� N c-�7og-oas <br />1 i l -7 3 s- <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />1), tC, CL,�LTF-ic (NG J_Y,1.t)wod0 WX 0687 <br />Electrical Contractor Mail Address City State/Zip Phone <br />D P1 i, I() a 0 E Z <br />State License Number Contract Price of Work <br />eJ,j00 <br />Proposed Use of Building I { J Contact Person (Plan Review) <br />Description of Work to Be Done: v I (A f U IJ49 <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 />1 hereby certify that 1 have read and examined this application and know the same to be true and <br />correct All provisions of laws and ordinances governing this type of work will be completed <br />whether speci(ed herein or not. The granting of a permit does not resume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.20 WAC. <br />Signature Dale V� �� <br />