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f <br />13 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wvvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />(a167'110c lu.��X�2W7 Tt/f0<?r-27 2f�206 t;s-s; <br />Owner Mail Address City State/Zip Phone <br />_//�ClfN <br />Tenant Mail Address City State/Zip Phone <br />r��;+l c/f'Ls o,ti s EcT ./UUN/ 72 c <br />Electrical Contractor Mail Address City State/Zip Phone <br />�) UAW4 /0'& Pz <br />State License Number Contract Price of Work <br />J;)U- /o/a <br />Proposed Use of Building / nn , /Contact Person (Plan Review) <br />Description of Work to Be Done: % ��/t/IGLGrT ? %/K //v Cj 0 /— J_)U f'L 6r . <br />0y CV_ kIi; /'oa)�cE . <br />��� (�¢2 �7%/lC f(�•I) ��/�/�(r. t (i / %< SQFT p/— JC/'Z/c/f�%'. <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 exarnined 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 regulating construction or the <br />pedormance of construction. That lam authorized by the owner of this roperty to perfomr 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 />� n <br />UG <br />Signalu Date <br />