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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, "'A 98201 <br />425-257-8810 - F' X 425-257-8857 — www.everettwa.org C p {—0-7 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Y�ts zs'� <br />/NeI�T� ��(�IST.Ie�rvScy <br />owner Mail Address city StateOp Phone <br />Tenant Mail Address city State/Zip Phone <br />Sr`a � i.NN - '& A- 9�d36 `�q � <br />Electrical Contractor Mall Address City State/Zip Phone <br />O <br />Slate License Number Contract Price of Work <br />/�Sij LF <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work toBe"-'rpone: Y... i � i rr N r 18APM dJA-WJ f% G Sru <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 applicatlon and know the same to be true and <br />correct. All provisions of laws and 0rdlnances goveming this type oI work will be completed <br />whether speci0ed herein or not. The granting of a permd does not presume to give authority to <br />violate or cancel the provisions 01 any other state or local law regulating construction or it <br />va la an a cf construction. That I am authorized by the owner of this property to perform the <br />work for which applicatlon !s made and 1 comply with the State Contractors Lew 18.27 RCW and <br />296.200 WAC. <br />Signature Date �O <br />