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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 - www.everettwa.org �o gd3-0% 2 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�V7 Ini <br />PROJECT ADDRESS <br />I� ()v41, C.>^5 �v <br />Owner Mall Address city StateZp Phone <br />5b <br />4 6 ) 8 al �)f, W Lwa+ _ <br />Tenant I Mail Address city State/Zip Phone <br />Electrical Contractor Mall Address City Ste elzip Phora <br />y.l b cC1A zy� o� _ e, k <br />Statee License Number Contract Price of Work <br />l-Vnse- <br />Proposed Use of Building yy�� 1 •' Contact Person (Plan Review) <br />Description of Work to Be Done: I t10 VI • U 7l <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 seme to be true and <br />crorrect. 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 regulating construction or the <br />performance of construction. That I am authorized by the owner of this roperty to perform the <br />work for which application Is made and 1 comply with the Staftr Contractors Law 18,27 RCW and <br />2�83T <br />�( <br />02 <br />Signature D to <br />