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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES S. <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857--www.everettwa.org 9 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />c- <br />PROJECT ADDRESS <br />flu I /� <br />5536p,5E.Zzn�( /iLy � I4 m t_`�l ,-%�42- <br />Owner Mail Address City State/Zip Phone <br />ycrl �,��l ice✓ ��2��/r G )Wfl U-6�?'(ekrl✓ /SNP l lkl �G <br />Tenant Mail Address tity State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />!NAWKEE1179M7 e0 <br />State License Number Contract Pnce of Work <br />D'p 4r L I k I goof Gi <br />P oposeF d Use of Building Contact Person (Plan Regw) <br />Description of Work to Be (ne - <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE /,} — <br />BE IN RACEWAYS, MC OR AC CABLE.-I1'/r��— <br />1 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read ante 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 ppresume to give authonty to <br />violate or cancel the previsions of any other state orlocal law regulating constru lion or the <br />performance of consiruction. 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 />Signature Datq <br />(�j[P <br />