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ELECTRICAL PERMIT "APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 -3 _ av -C-9 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />a9o3-n99 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />_ f� <br />�/ ll1eye� /2906 Az9)l4e`l 4f IV41 cJ 9riZo$ m <br />Owner Mail Address City Stale/Zip Phone <br />SAIML — <br />Tenant Mail Address City State/Zip Phone <br />tS 510 T s lukkvl/<t /�8 -Y-5 -Isc/� <br />E ectrical Contractor Mail Address City Stale2ip Phone <br />Slate License Number Contract Price of Work <br />6WQ/ <br />Proposed Use of Building -- �� / Contact Person (Plan Review) <br />Description of Work to Be Done: 461a) V %19e-- 'hone t I%A''T 1 CCTV _ <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 />I hereby certify that 1 have read and examined this application and know the same to be true and I J J 1 <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 ; ithority 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/ comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC <br />Signature Uale <br />