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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8010 - FAX 425-257-8857 — vmv.evereftel.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8. CREDIT CARDS ARE NOT ACCEPTED <br />-1 <br />JM 2-2 �d 2' eve /rizt. �oso�a <br />PROJECT ADDRESS j <br />% 1 V-1 a r�a [L� zij 71Z- zZs Pyer^e ff but�S 3i9o%3y/ <br />Owner Mail Address city Statelzip Phone <br />Tenant Mail Address city State2lp Phone <br />-� ,M7j _Z045-�027 <br />Electrica Contractor Mail Address city J Slaledip Phone <br />Slate License <br />Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: C <br />YiA e <br />57 <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 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 />penormance of construction. That I am authorized by the owner of this roperty to perform the <br />work for which appli lion is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />5-1gliature Date <br />FF <br />