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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 S `4D 1-0 a <br />425-257-8 10 - FAX 425-257-8857 - vvww.everettwa.org C d qOS--O Z <br />APPLICATION., ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />7u )%nrjer CL?. <br />%rr�s <br />Owner Mail Address City State/Zip Phone <br />Tyre' K 142111r mull - &'a✓�l� �U1J �/i�� Pff llkt ���G� <br />Tenant Mail Address tity Slate/Zip Phone <br />17aIM'rl'%�7r' 'lam/liz Il�%7 llillcu� 111 �i-t� 4_7L - <br />Electrical Contractor Mail Address City State/Zip Phone <br />HAWKEE1179M7 ,^ <br />Stale License Number / ��� Contract P•ice of Work <br />- C �1 n <br />P oposed Use of Building Contact Person (Plan R v w) <br />Description of Work to Be Done:•UQ.- <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 I have read and examined this application and know the same to be true end <br />correct. All provisions of laws and ordinances governing this type of work will be comphted <br />whether specified herein or not. The granting of a permit does not iresume to give authority to <br />violate or cancel the pprevisions of any other state or local law regu%afing construction or the <br />pedorman:,a of construction. That/ am authorized by the owner of fh;s property to perform the <br />work Ior ch application is made and 1 comply with the State Contractors Caw 18.27 RC4V and <br />296.200 WAC. <br />gnalure Ca r C) 0lz <br />