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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 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBI r & CREDIT CARDS ARE NOT ACCEPTED <br />3 z / S_ z / -5r .ST- ?rB _ <br />PROJECT ADDRESS <br />M t-, IK) i_y i�l f` %L 13R()A _ <br />Owner Mail Address City Slate/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />MLbINJ_) x rLrc(7))QL rp /"Q V.2 zSZ_- 41�0?7 <br />Electrical Conlrac or Mail Address City stale/Zip Phone <br />MCV/NF_ LeC3 ii%J <br />Slate License Number Contract Price of Work <br />EXSfj f1✓V /-Eq J LIPLF <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: Rr f /1IK M r:_T,-: f aCkF_T OF urvi % <br />I - TALLJ <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />.3S od <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and 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 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 fo perform the <br />work for which application is made and 1 comply with the State Contractors law 18.27 RCW and <br />296.200000 WWA�C. <br />�l lsi nature Dale V/ <br />J�p-/ <br />