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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 /> PROJECT ADDRESS <br /> Owner Mail Address city State2lp thane <br /> Tenant Mall Address (.1i. Stalemp Phony <br /> /'tacei���r;/ �/,._�-ti.r � s-6 �S �8Y"t' S1 S� Sn�io�'s/c �✓a �frZ9c; <br /> Electrical Contractdr Mall Address City State/Zip ��15 870 Phone <br /> 9S-'r 11+ S-44`_lT <br /> Slate License Number Contract Price of Work <br /> Props,-Ld Use of Building // Contact Person (Plan Review) <br /> Description of Work to Be Done: Ivo-x <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 /> "'am' <br /> certify that I have read and examined this appmlcation 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 notpresume to give authority to <br /> virmate 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 /> 286.200 WAC. l <br /> ign u r Dale <br /> C O5f0 -I 35 <br />