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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 />I <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />PROJECT ADDRESS <br />/- /C y1S) 3S'S 31 fi'� <br />IOW1 I�1 r ��uC S CYe2j� L.p 7WjC) <br />Owner Mail Address City State/Zip Phone <br />sy'� r^r%e <br />Tenant Mail Address City Slele0p Phone <br />yas <br />Electrical Contractor Mail Address City State/Zip Phone <br />HrtLLE(-* 05F')G 3oo-Q <br />State License Number Contract Price of Work <br />VCeSL,oul <br />Proposed Use of Building j \Contact Person (Plan Review) <br />Description of Work to Be Dane: (Z..0 f CV t 1 & cc `y C� f 1� Y`t 115� t u vl YU <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 <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether spec reed herein or not. The granting of a permit does not presume to give authority t0 <br />violate or cancel the pr0vfstons of any other state or local law regulating construction or the <br />performance 01 construction. That I am authorized by the owner of this roperty t0 perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Signature Date <br />