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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 (= O S/ 2 � 1 S1, <br />425-257-8810 - FAX 425-257-8857 — www.everettvva.org i <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ^�{ I� <br />DECU J <br />CITY OF EVERETT <br />PROJECT ADDRESS Engineering/Public Services <br />Ffzj') McAc--,P, PO 13yX 112121 PoRT11WD cQ ���i2�iZ 503 7Tl 11 %5r <br />Owner Mail Address City Statelzip Phone <br />r�n 2-9 0 (D P�mJl Eur F Q6EPA - W 1 FQe90rr f WA 98'2og <br />Tenant Mail Address CRY state2lp Phone <br />We.sTcPw 2700 IS' Av- C '�FA-TTLE- V01-1 CJS k 3 � z°C' u&Z 77 <br />Electrical Contractor Mail Address City State/Zip Phone <br />Slate License Number Contract Price of Work <br />/ <br />1 V `QYC. I.,o.W renC.Q, <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: I r 15TAVI, aAL FW5 f] A)t=. A C410y/ EJ, <br />NOI E: WIRING IN NON -DWELLINGS IS REOUIRED 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 I 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 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 rugulahny- construction or the <br />perfopropertyrmance 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 />296.200 WAC. <br />s gna Date <br />