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w _ <br /> ti <br /> 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 - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> I 1115 5 7-n� ST 55 <br /> PROJECTADDRESS <br /> 14AA(,K ►3f nS cvt.,sT <br /> Owner Mali Address City State/Zlp Phone <br /> Tenant Mall Address city State/Zip Phone <br /> SymrnITCICG Ic 1NG 6203 261Sr Sr Ni S- n� ckwfo W11 �8z92, <br /> Electrical Contractor Mall Address city SWte/LpylPh ne5 ion S)S�j <br /> SyMMlC1 066 50U <br /> State License Number Contract Price of Work <br /> F IL <br /> Proposed Use of Building o r Contact Ferson (Plan Review) <br /> Description of Work to Be Done: ('1) <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 o/laws and ordinances goveming 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 /> peAormance of construction. That I am authorized by the owner o/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 /> Signature Date <br /> FuS�� ` � <br />