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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 <br />�►2-:W ST sC- <br />PROJECT ADDRESS <br />Owner Mail Address City SlaterZip Phone <br />Cz,,�II 5Wc gck6 M sT NC Mamjsv lie wA `L_qL) 6 Phone one <br />Tenant Mail Address City State/Zip <br />94D6f 1 F-K AZz \y - q q- <br />Electrical Contractor Mail Address City State/Zip Phone <br />NouC1C<_' A*-q--)-/1--/1512-- 9,o60.c2 <br />Slate License Number Contract Price of Work <br />�aj Q 0\ d <br />Proposed Use of Building Contact Perso Plan Review) <br />Description of Work to Be Done: 1 <br />e(Ll_� 11�tn��rlS circ L.6 L)n ha tioc_> A, <br />o� <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 same to Fe 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 authonty 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 property to 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 />�z <br />� Si na Date <br />